Moving to New Zealand because you’ve heard its ‘free’ health service is world class, or maybe you’re a medical professional hoping for a better working environment?

Think again, when it comes to health care you get what you pay for. (Read our posts tagged health service)

The Association of Salaried Medical Specialists is so concerned about the lack of public hospital specialists in New Zealand that it has issued a press release warning that sub-standard conditions have become the norm in the small Pacific nation. Not only could this cause cuts in clinical services but it is also causing a retention crisis for both junior doctors and specialists.

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Entrenched public hospital specialist shortages becoming increasingly unsafe

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Media Statement – Ian Powell, Association of Salaried Medical Specialists

3 February 2013

“Many public hospitals will need to reduce services in the near future as a result of continuing shortages of medical specialists,” said Mr Ian Powell, Executive Director of the Association of Salaried Medical Specialists, today.

Mr Powell’s warning comes with the release of a comprehensive report by the Association on key issues concerning the demand and supply of specialists in New Zealand public hospitals. “The report’s conclusions are based on the best health intelligence available.”

“Specialist shortages, which have existed for many years in many areas, have become so entrenched that the resulting sub-standard conditions have become the ‘norm’. Public hospitals are not retaining enough of the specialists we train, are not recruiting enough specialists to fill the gap, and are not retaining many of those we do actually manage to recruit.”

“As a result, hospital specialists are caught between the proverbial rock and hard place. On one side they have increasing clinical workloads. On the other there is mounting pressure to spend more time supervising and training resident (junior) doctors, and engaging in clinical leadership activities.”

“Up until now services have been held together by specialists giving priority to meeting patients’ clinical needs at the expense of their supervising, training and leadership roles. But that situation is becoming increasingly unsafe, it is limiting the training and experience of our future specialists, it is hugely wasteful, and is contributing to a high turnover of both resident (junior) doctors and specialists.”

“This assessment is based on government documents, published research and the most recent workforce data from the Medical Council of New Zealand and District Health Boards.”

“Unless there is an urgent quantum leap towards addressing our retention crisis, we are approaching the point where there is no option but to cut clinical services,” concluded Mr Powell.

ENDS

You may also be interested in our NZ Health Wiki which has specific sections headed Health Service – effects on Patients, effects on Staff;  Under Staffing* and Inefficiencies.

*Under Staffing

• There is a workforce crisis in New Zealand’s hospitals. Specialist senior doctors are being lost and there is a shortage of cancer specialists. Staff are lost to Australia (where the salaries are 35% higher) and to private practice. The causes are low pay by international standards, overwork and lack of resources to do the job.

• New Zealand has an estimated shortage of around 600 specialists and that’s set to get worse, according to the Association of Salaried Medical Specialists. Growth has not kept pace with increasing need in an ageing population.

• The senior doctor’s union estimates there is a shortage of 638 medical and surgical specialists and that having to treat too many patients is driving doctors away from NZ. The country “needs at least 1100 more specialists if it were to match the number per head of population in Australia, the union says in a discussion paper based on data from 2007 and 2008.” Source NZ Herald.

• New Zealand’s has a high dependence on overseas-trained doctors, the highest in the OECD , who comprise 40% of specialists. In some areas, such as psychiatry, the figure is closer to 60%.

• So many NZ trained registrars go overseas when they’re qualified that it’s hardly worth training them at all. Medical registrars can earn around $70,000 more in Australia and  difference in salaries is one of the major drivers for the exodus. “The situation is a crisis and a crisis generally comes before a collapse” -says Association of Salaried Medical Specialists executive director Ian Powell.  See the bullet point above for the other drivers.

• “New Zealand’s paediatric surgeon work force is declining as trainees are lured to Australia… Between 2005 and 2009, the number of paediatric surgeons dropped from 16 to 14. Christchurch Hospital clinical director of paediatric surgery, Spencer Beasley, said New Zealand needed 18 or 19 paediatric surgeons. There was a worldwide shortage and only three of the past eight Kiwi trainees are working in New Zealand.“

• Junior doctors at Christchurch Hospital say patients and doctors are at risk because of understaffing. A spokewoman for the RDA said that over the last 4 weekends there weren’t enough junior doctors on duty. The acute area only had 3 out of a necessary 5 juniors and there was neither an orthopaedic house surgeon, nor an acute-surgical house surgeon on duty over the weekend, or the previous night. According to a report in The Press the doctors were supported by the out-of-hours clinical coordinators who had written to the CDHB chief executive saying that “shortages were compromising patient safety.” (27 Jul 2010)

• A surgeon has been censured again for speaking out over his concern about the safety of radiololgy services in W(h)anganui. ”Mr Solomon said in March a single Whanganui radiologist was doing the work of three doctors and was being paid more than $600,000 a year – three times the usual radiologist’s salary…In 2007, Mr Solomon was censured for the first time by the board, for speaking out about patient safety fears because of alleged staffing shortfalls.” (July 2010)

• “Taumarunui Hospital is facing a critical shortage of qualified medical staff after one of its remaining two doctors resigned in the wake of the town’s after-hours care crisis.” (March 2010)

Related articles

• Report: Hospital cutbacks looming (nzherald.co.nz)
• Report on specialists leaving NZ welcomed (radionz.co.nz)
• Specialist doctors continue to quit New Zealand (stuff.co.nz)
• Minister disputes staff shortage claims (nzherald.co.nz)
• NZ medical experts brace for arrival of deadly flu (nzherald.co.nz)
• Legal action against DHB considered (radionz.co.nz)
• Hospital and midwives criticised over baby death (stuff.co.nz)
• Doctors’ union says specialist shortage a safety risk (radionz.co.nz)
• Patient alert system for disease ‘not carried over’ (nzherald.co.nz)