Editorial: Doctors risk losing credibility

Junior doctors have voted to strike from next week over long working rosters. Their union secretary, Deborah Powell, says their hours are endangering patients' lives. How often have we heard this? Every time hospital doctors are due to renegotiate their collective contract with district health boards, Ms Powell makes the same announcement: her members are exhausted and frustrated with the lack of a reduction in their hours, they are making mistakes, patients are not safe ... and every time, after a period of upheaval in hospitals, the doctors and the district health boards come to some sort of agreement. But it never seems to solve the problem.

It must be wondered whether Ms Powell's union really wants a solution to it. In a previous era of labour relations, when strikes were far from the last resort in strongly unionised industries, there was a great deal of ritual in which bargaining agents of both sides played a knowing role. Sometimes the same grievance would be revived year after year to provide leverage for a wage rise. Is this the tactic being recommended every year to the members of the Resident Doctors Association?

Several elements of the dispute support that suspicion: First, young medical graduates serving time in public hospitals are not lacking bargaining advantages. They are intelligent, resourceful, they can easily summon public support and, most important, there is always a shortage of them.

Second, they are negotiating with agents of a Government that is softer than previous ones when it is asked to fund public service pay settlements. A great deal of this Government's higher spending has been absorbed by the state payroll. Nurses, for example, have recently pocketed a large proportion of increased health funding after a determined public push for better rates. District health boards seem to get away with running routinely in deficit now.

Third, despite the dire warnings of the junior doctors' union, nothing calamitous ever happens. Whatever form the strikes take, district health boards are given good notice and they seem to go by without too much difficulty. Doctors undertake to do their duty in emergencies but, even so, a serious reduction in their services could be expected to result in more pain than is usually evident.

None of these observations is intended to suggest junior doctors do not work by rosters that can be exhausting and increase the risk of errors. They do. But it seems to be a rite of passage to the well-paid medical profession here and in many countries. Last Friday we published a letter from a doctor in Ireland who trained in New Zealand, Joseph Baker. He said: "I am disappointed the threat to strike has risen again. From my memory, the hours were acceptable, the workload satisfactory and at times light ... my experience overseas so far suggests that conditions for junior doctors in New Zealand are enviable and the system is an excellent one to train in."

An American expert on the effects of sleep deprivation, brought here to advise the boards in the current negotiations, says the workload of New Zealand's house surgeons and registrars compares well with those in the United States. His study of the effects of fatigue are likely to bolster the doctors' case this time but nobody seems to be holding their breath that the issue might be resolved this time, once and for all. It is dangerous to cry wolf too often. This could be the year Ms Powell's members mean it. Health boards must take the risk seriously and make their usual preparations. But it seems safe to say patients need not worry much. And the rest of us, hearing this warning yet again, must be forgiven if we no longer find it credible.