Delegates at last week’s Association of Salaried Medical Specialists (ASMS) conference voted unanimously to lobby the Minister of Health to back a safe staffing accord for public hospital senior doctors and dentists.

Earlier this year nurses’ frustration over longstanding safe staffing issues at the 20 district health boards lead to strike action and also to the signing on July 30 of a Safer Staffing Accord between the New Zealand Nurses Organisation, 20 DHBs and the Ministry of Health.

Now the senior doctors and dentists union ASMS is calling for the Minister Dr David Clark to “actively support” forging a similar accord between the ASMS, the Ministry of Health, and the 20 DHBs.

“Hospital specialists, like nurses and other frontline health workers, continue to suffer from high workloads caused by years of under-resourcing and neglect of the public health system, and problems with high levels of burnout and forced to work while sick and infectious,” said ASMS Executive Director Ian Powell following the conference.

He said ASMS surveys indicated that 50 per cent of specialists were suffering burnout and had high levels of job dissatisfaction. Also the sector was facing specialist shortages of around one-fifth which was made worse by about a quarter of specialists intending to leave the public hospital system within the next five years.

Factors behind the precarious state of hospital specialist workforce in DHBs

  • Funding in real terms decreased by around $2b from 2009/10 to 2017/18 (Vote Health Operations, mainly DHBs)

Year to June                    Hospital discharges              Acute readmissions

2013                                 811,064                                         89,898

2017                                 912,749                                         107,415

% Increase                       +12.5%                                           +19.5%

Population growth for this period: 7.2%

Sources: Ministry of Health 2018Statistics New Zealand 2018.

“This is neither sustainable nor fair, and it is not good for patient care. One way of making meaningful progress to address these problems would be through a safe staffing accord between ASMS, the country’s 20 district health boards, and the Ministry of Health.”

Dr Deborah Powell, National Secretary of the New Zealand Resident Doctors’ Association said resident medical officers (RMOs are junior doctors ranging from new graduates through to specialist registrar trainees) back the call as they have firsthand experience of senior doctors suffering burnout as these are the specialists who support, supervise and teach RMOs.

“Unfortunately resident doctors are increasingly aware of just how fragile many of their SMOs (senior medical officers) are becoming. The demands of excessive patient workloads need to be addressed urgently,” said Deborah Powell.  She said the high SMO workload directly impacted on the level of support that RMOs could provide patients.

She believed too few SMOs were being employed for the increasing level of patient care required.  “We believe the DHBs make decisions about SMO staffing levels largely driven by cost considerations,” she said. “However, there is also a human element that must take priority. The wellbeing of SMOs is of serious concern to resident doctors, not just because they rely on their supervision, support and training, but also because today’s resident doctors are tomorrow’s SMOs. From a wellbeing perspective, the future is looking pretty bleak.”

Indicators of the health and well-being of the senior medical workforce in DHBs

Ian Powell said Clark played a constructive role in ensuring the nursing safe staffing accord.  “All we are asking is that he does something similar for overworked, highly stressed and burnt out senior doctors.”


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