Commision backs radical changes to doctor training

File photo / The Aucklander

Radical changes to the employment and training of hospital doctors have been recommended this afternoon by a Health Ministry-appointed commission.

Resident medical officers - new-graduate doctors and trainee specialists - are now employed mainly by the 21 district health boards.

But the report of the Commission on the Resident Medical Officer (RMO) Workforce, headed by former state services commissioner Don Hunn, recommends creating a stand-alone agency to employ all of New Zealand's 2500 RMOs.

The commission was appointed last year after years of repeated industrial strife in the re-negotiation of the multi-employer collective agreement between the health boards and the Resident Doctors' Association.

In its report, released this afternoon by Health Minister Tony Ryall, the commission says, "New Zealand's RMO workforce is characterised by dissatisfation, industrial conflict and fragmented approaches to workforce management and planning.

"Associated issues, including the shortage of RMOs and the increasing cost of providing RMO cover [casual locums to cover vacant hospital shifts], are a threat to the ongoing effective management of the public health system."

The commission is critical of health boards for too often giving precedence to work over the training needs of RMOs (house officers and registrars).

"For RMOs to be treated primarily as an in-training workforce requires changes to a system that relies on them as a frontline workforce."

Many, especially those in their first two working years after earning their medical degree, consider they are not receiving the teaching they are entitled to, and are frequently assigned to "low-level and professionally unrewarding" clinical and administrative tasks.

"... they do not feel valued in the workplace. They report feeling that their employers view them as units of labour to be deployed to cover service need rather than professionals in training, with families and lives outside the workplace."

"There is a serious deficiency in the level of pastoral care for RMOs...."

The commission thinks it would be too much to expect the 21 health boards to make the necessary changes and calls for national leadership of RMO training and the establishment of a single employer of RMOs supported by regional or local units.

Like the commission on senior doctors, which reported last month, the RMO commission has avoided recommending pay levels - considered a fundamental issue by the Resident Doctors' Association, which says New Zealand needs to draw closer to Australian levels to help stop the loss of doctors across the Tasman.

The senior-doctors commission found that public hospital specialists were paid 30-35 per cent more in Australia, mainly because it was a wealthier country than New Zealand.