Editorial: Group brings new twist to doctor roster

It was always more likely some of the young doctors did not mind the long rosters too much, giving them longer breaks in between. Photo / 123RF

Editorial

How many times over the years has the public given unquestioning support to the Resident Doctors' Association when it complained that junior doctors' rostered shifts were not safe? The union has managed to drum up public support every time it took direct action at a cost to patients awaiting attention, to put pressure on district health boards in pay negotiations. It was one of those problems that seemed to return no matter how often the dispute was settled.

But thanks to a breakaway group of trainee surgeons, we might have heard the last of that argument. After the DHBs agreed to revise the rosters from 12 days to 10 days last year, the group of 50 budding surgeons formed a new bargaining collective called Specialty Trainees of New Zealand (SToNZ) and it has just negotiated a new agreement with the DHBs that allows them to work 12 days in a row.

The group's chair, Heath Lash, has explained that a 10-day roster seriously restricted their training. It meant that after working a weekend he would have to be off on two weekdays when operations and meetings were scheduled that were important to his training. The 10-day roster was also less safe for patients, he argued, because it increased the number of handovers from one doctor to the next when mistakes could occur.

The national secretary of the Resident Doctors' Association, Deborah Powell, continues to insist a 12-day roster is unsafe. She told Radio NZ the rival deal would mean two unions would be operating in hospitals with fatigued doctors in one of them. "Patients may be forced during the informed consent process to actually ask, 'Well actually, how many days have you worked before you operate on me?'"

Unlikely. Patients will trust surgeons and trainees to know their safety thresholds. Powell still represents the great majority of junior doctors with 3500 members and is threatening more strikes in the next round of negotiations in March if the DHBs try to impose the StoNZ roster on them. But it is hard to see why the DHBs would do that.

As things stand, resident doctors have a choice. If they find a 12-day shift too exhausting they will stay in Powell's union, if they find a 10-day shift bites into their training and interferes with the continuity of attention they can give to patients they will join the trainee surgeons whose group now numbers 100.

It was never very credible that hospital managers would, or could, force unsafe working conditions on medical professionals, including trainees whose work would be of interest to the specialist colleges they were training to join. It was always more likely some of the young doctors did not mind the long rosters too much, giving them longer breaks in between.

Many patients awaiting elective surgery or diagnostic tests would have faced stressful further delays as a result of junior doctors' strikes. They deserved a better explanation for them. Next time they might get one.