Doctors go back to work with hopes for a deal

Auckland City Hospital is full tilt, says a manager. Picture / Paul Estcourt

Junior doctors returned to work today, and signs looked positive for a settlement in the bitter dispute that led them to strike for five days.

Mediated talks yesterday between district health boards and the union representing about 2400 junior doctors were adjourned until Thursday, when full negotiating teams from both sides will meet.

Dr Nigel Murray, the boards' advocate, would not comment further, other than saying the two parties would consider a fourth version of the Memorandum of Understanding - the document at the heart of the dispute.

Resident Doctors' Association general secretary Deborah Powell said the parties were "working on a new way forward".

"We're certainly talking about a settlement."

Public hospitals yesterday were gearing up for the resumption of normal services after the strike left hospitals making do with reduced staff numbers.

Anne Aitcheson, the health board's national coordinator for contingency planning, said it would take up to two days for full services to resume at all hospitals.

"Some of the small boards have got quite a lot of work with acute patients still to do tomorrow, and they may not start some of their electives until Wednesday or Thursday."

Mrs Aitcheson said the backlog of cancelled clinical appointments and elective surgery would take some time to clear.

"For patients, it does mean a longer wait than would otherwise have been expected."

Public hospitals such as Auckland City and Waikato were yesterday preparing for the end of the strike.

"We're full tilt," Auckland City Hospital chief medical officer Dr David Sage said.

"We're filling up with patients for surgery. Occupancy is over 90 per cent."

The numbers of patients with acute medical conditions such as pneumonia remained at normal winter levels during the strike, he said.

About 2100 patients had outpatient appointments or non-urgent surgery postponed at Auckland District Health Board facilities.

Patients were now being contacted about their new dates, he said. Some might have to wait for up to a month.

Waikato Hospital was also admitting patients yesterday in preparation for the end of the strike.

Its acting general manager of health services, Jan Adams, said the hospital was steady over the weekend, and had about 290 patients in hospital beds yesterday morning - just over half the usual number.

The emergency departments also had 20 per cent fewer patients than usual on Saturday and Sunday.

It postponed 300 operations and 1000 outpatient clinics last week.

Although the hospital expects to be back to normal within a week, some patients will wait up to six weeks for their new appointments.


WORKING PARTY OR COLLECTIVE AGREEMENT?

The dispute centres on power and who has it.

The junior doctors' union says the key issue is that district health boards want to sideline the national multi-employer collective agreement - which governs pay, hours and other working conditions - and replace it with a "committee".

The employers say the agreement is an inflexible document that allows the union to manage hospital staffing levels - an "intolerable" situation.

They say it requires more junior doctors than the country has, leads to more being rostered on duty than are needed on some shifts, and fosters conflict such as this strike. The boards want a new working party (the committee) set up to negotiate changes such as reduced working hours - something both sides say they want.

It would negotiate the likes of trials of different local rosters, which, if considered a success, could be codified in the main agreement, the boards say.

The first draft of the memorandum of understanding to create the working group gave the boards four seats on its executive and the union three. This led to claims of employer dominance, but a boards representative says the arrangement also gives the union veto powers over any proposal.

Subsequent memorandum drafts have given each side three and now four seats on the executive - and retained the union veto.

But the union is unwilling to shift negotiations from an agreement that has served it well and which it says is where Parliament, through the Employment Relations Act, intended the formal talks to take place.

Industrial muscle is the underlying issue. By law, the union can generally take industrial action only after negotiations for an agreement have started, not while one is in force.

- Martin Johnston