DHBs, union clash over plan to axe 20 doctors

Plans to cut 20 resident doctor positions at Auckland hospitals will increase the pressure on remaining staff and threatens standards of patient care, a unionist says.

But the health boards say the jobs will be replaced by 20 new positions in departments such as emergency medicine, geriatric care and paediatric intensive care, to provide more training positions where doctors-in-training had indicated they wanted them.

The health boards are also using the changes - expected to reduce vacancies - to push down some of the high rates that locums have been able to demand in Auckland because of a chronic shortage of resident doctors.

Rates were capped in 2007 at $120 an hour for house officers and $150 for registrars for the least popular shifts - nights, on Friday and at the weekend. Resident Doctors' Association secretary Deborah Powell said yesterday the boards proposed to scrap the 20 jobs by next month , because they had long been unable to attract permanent employees for them.

They include positions in psychiatry, obstetrics and gynaecology

The vacancies had been covered by locums and by other staff working longer hours or taking on larger numbers of patients. The longer hours would now become permanent.

"Many doctors' hours will increase from around 52 hours every week to at least 62 hours.

"The DHBs' callous disregard for the impact that tired and fatigued doctors has on their own health and wellbeing, as well as that of their patients, is intolerable."

She said increasing resident doctors' pay and offering more flexible working conditions would help address the shortage of them.

Auckland District Health Board deputy chief medical officer Dr Margaret Wilsher said the new positions would start from November 30.

They covered general medicine, surgery, anaesthesia, rehabilitation and paediatric intensive care.

"Counties Manukau is to implement a new geriatric medicine team to meet long-term ageing population requirements, while North Shore Hospital is to benefit in its emergency medicine department with the creation of five new house officer roles."

Dr Wilsher said that where jobs had been eliminated - because the work had transferred to another health board or the roles were unpopular and unfilled - the boards had tried to reduce workload or provide services by alternative workforces.

But where alternatives had not proved feasible, hours of work had been increased as permitted within employment agreements.

She said that because of reduced vacancy levels after introduction of the changes, Auckland's health boards could cut locum pay rates back to the levels paid nationally, except for registrars in general medicine, where the demand was still great.