Disbelief as Government does nothing during a crisis

Dr LES GALLER is an intensive care specialist in the Department of Critical Care Medicine at Auckland hospital. He sent this message to MPs in a bid, he says, to raise concerns about the radiographers' strike and its implications. This is an abridged version.


I cannot be regarded as Auckland Hospital's official spokesman and am speaking as an individual, though with the support of many of my colleagues, intensive-care specialists working in Auckland Hospital.

The strike at Auckland and Green Lane hospitals poses a city-wide, major threat to acute health care in Auckland and its outlying regions.

This strike is quite different to those previously that have involved junior medical staff or nurses. In those strikes there was major inconvenience, the cancellation of elective surgery and there were risks of transporting critically ill patients to other centres.

This time, the hospitals cannot function as acute-care areas in any proper sense.

Acutely ill patients have a high requirement for both diagnostic and therapeutic radiology. If these are unavailable, or available only in a very limited way, then patients within the hospitals affected, or who are brought to the hospitals affected, are at increased risk. They cannot be diagnosed or treated as effectively, safely.

Other centres will have to find the capacity to accommodate these patients, which will have an impact on what these hospitals can offer to their own regions.

I would urge that the two sides of this industrial dispute immediately settle, and if this does not happen then I believe that it is the Government's responsibility to intervene and settle it one way or another.

Clearly the issue is the Government's unwillingness to redirect any more money towards this aspect of the health sector - the decision is ultimately theirs and not just Auckland Hospital management's, and the responsibility of what happens is therefore also theirs.

The Government has instructed the board management not to agree to anything over a 2 per cent wage rise, which is less than the rise in the cost of living.

Already this dispute has caused a massive disruption to the acute and elective health care delivery to Aucklanders.

Failure of the Government to intervene and bring this matter to a resolution should be regarded by the public of New Zealand very seriously indeed.

The Government is allowing the health of the public of Auckland to be compromised and it must be accountable for this.

I find it incomprehensible how such a major crisis can be allowed to continue without some form of intervention.

It is all very well for the Minister of Health to say it is not her responsibility, but if the responsibility lies anywhere it is with the Government, which must intervene to stop it from happening or curtail it.

No one is denying the need for change and a new look at the delivery of regional services in wider Auckland.

However, to achieve the best outcome in such a complex and varied organisation as the Auckland District Health Board there needs to be a very close working partnership between the clinical staff and the management. This requires familiarity with the problems, an understanding of each other's concerns, skill, collaboration, mutual respect and trust.

There appears to be a history of unsatisfactory relationships between management and clinical staff, and the ever-transient nature of the management structures has caused at least some of this.

The views of the board's medical and nursing staff have been repeatedly excluded or ignored in the planning processes.

Furthermore, there is no close, trusting relationship or partnership between clinical staff and the management in the board. That bodes badly for the future planning of health care services in Auckland city as well as having serious implications for regional, hospital-based services.

All of this has led to a progressive loss of goodwill by the clinical staff of this organisation and this results in more and more of the kinds of disruptions that we are now seeing.

At the end of the day, the erosion of staff goodwill towards the management, especially in a large public institution, will impact heavily on that institution in many ways.

I believe that it is the public of Auckland's right to know exactly by how much this whole disastrous exercise has increased the all-important deficit.

Further reading
Feature: Our sick hospitals