Senior staff pitch in to cover serious junior doctor shortage

Nurses and senior doctors are pitching in to help cover for a serious shortage of junior doctors at Auckland's public hospitals.

And locums are being hired at sometimes twice the hourly rate of permanent junior medical staff.

Around 70 (7 per cent) of the region's 990 house officer and registrar positions are vacant.

The worst shortages are among house officers, who are the more-junior staff.

The Auckland District Health Board's director of clinical training, Dr Stephen Child, said yesterday that there was usually a shortage of junior doctors at this time of year, but this year it was worse.

It had been worsening for several years partly because the number of positions had increased by far more than had the output of the two undergraduate medical schools.

It was exacerbated this year by a sharp decrease in the number of overseas doctors coming to New Zealand.

"The whole system gets pressured and stretched, but I believe that patient safety so far is maintained. If we don't redesign our workforce, the problem could start to be a crisis."

The Resident Doctors Association, the union for junior doctors, says it already is a crisis.

"But this is just the beginning, with the lowest rate of applications for new positions since 2002 ... ," said the general secretary, Deborah Powell.

She blamed the shortage on the "aggressive" strategy of the 21 district health boards to "remove" the national collective agreement covering junior doctors. This was driving them to Australia, where, in New South Wales, health agencies were advertising for nearly 1000 junior doctors, she said.

Around 2000 of the country's 2500 junior doctors went on strike for five days in June after talks between the union and the health boards broke down, but the parties have resumed talks.

The health boards say the union has misinterpreted their intention, which is to introduce more-flexible working arrangements.

Dr Powell said Middlemore Hospital was one of the worst affected by the shortages and in one service it had responded by increasing junior doctors' hours to a less safe level.

Middlemore clinical director of medicine Dr Jeff Garrett said: "Four weeks ago we were looking at curtailing services.

"Now we've got a critical number to get by; we don't need to curtail."