Editorial: Why are junior doctors still working these dangerously long shifts?

Young doctors, newly graduated, have to serve eight to ten years as residents in hospitals before they can train as specialists. Photo / Lewis Gardner

Editorial

How many times over the years have we seen the junior doctors' union complain about the unconscionable hours they work in public hospitals? The issue usually arises when their union, the Resident Doctor's Association, is in negotiations with district health boards over the doctors' pay and conditions and a strike is threatened or scheduled, ostensibly over their unreasonable hours.

Eventually the contract is settled but not, it seemingly always turns out, with much progress on the rosters - for the next time negotiations hit an impasse, we again hear the doctors are working ridiculous shifts. This time they have given notice of a 48-hour strike the week after next, complaining they are working 10-15 hour days, 12 days in a row.

What is going on? If the rostering is really the issue, why was it not solved long ago? If the Resident Doctor's Association was failing each time to negotiate settlements to its members' satisfaction, its national secretary, Deborah Powell, would surely not have survived in that role all these years.

It is hard to avoid the conclusion the rosters are being used for leverage on issues more important to Powell's members and that the issue is leverage they do not want to lose.

Be that as it may, the rosters are unreasonable, ridiculous and dangerous for public hospital patients. Nobody wants a sleep-deprived resident doctor trying the deal with their medical emergency after being on duty for 12 hours or on the 12th day of their shift. If this is not the central issue in the negotiations, the public is being let down. Both the union and district health boards should feel an obligation to establish sensible, reasonable rosters once and for all.

How hard can it be? Hospitals have to work around the clock. Nurses and other staff are rostered to provide essential care at all time of the day or night, yet we seem not to hear the same problem recurring like this. If their rosters are acceptable, why cannot the resident doctors copy them?

Young doctors, newly graduated, have to serve eight to ten years as residents in hospitals before they can train as specialists. In the general hospitals they get a practical grounding in a wide variety of medical issues and learn to deal with emergencies and make decisions under pressure.

Doubtless they frequently continue attending to a patient beyond their scheduled hours. Later, they look back on the rigours of those years as a valuable experience. It is not unusual to hear them say they accept long hours as part of the training.

But if mistakes are being made under fatigue, as the union says and some of its members attest, public safety demands hours be reduced. A union survey finds 1182 members have made such a mistake and 275 say they have fallen asleep driving home.

The DHBs responds that its own survey has found no resident doctors admitted to making mistakes under fatigue or falling asleep at the wheel. But the subject is too important to be under negotiation. Patient safety demands that hospital doctors are alert. It should not be a bargaining point.