'Line in the sand' as junior doctors strike
Striking junior doctors say they are not prepared to wait for two to three years for safer working hours.
The public is being urged not to visit hospital emergency departments unless a life is at risk with up to 3000 junior doctors walking off the job.
All non-urgent hospital services have been cancelled for two days. Senior doctors would provide acute and emergency care at the nation's hospitals.
District health boards (DHBs) are advising the public to seek care from their GPs during the 48-hour junior doctors' strike over safe hours of work, from 7am Tuesday.
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Hundreds of elective procedures and operations have been rescheduled, allowing some nurses to take annual leave.
STRIKERS WAVE SIGNS
Striking resident doctors are making their cause known to the public at a protest in Christchurch.
A group of 40 – 50 striking doctors gathered outside Christchurch Hospital as the strike got underway this morning.
With signs making their cause clear, the group attracted a chorus of toots from passing cars, including support from two Police paddy wagons.
One sign read: "I would have made a better sign but I was working nights."
New Zealand Resident Doctors' Association (NZRDA) delegate Jonathan Davis said they were "drawing a line in the sand".
"We are not willing to wait two or three years for this to happen," Davis said.
The decision to strike was "really difficult" but members felt it was the right thing to do.
"None of us want to go on strike we would much rather be at work. We've been put in this position by the DHBs."
"We can all recall positions we've been put in where we know we are too tired to think properly, we know we are struggling."
Davis, 33, said the effect of the strike on patient care at the hospital would be minimal, with sufficient senior doctors to cover their absence.
"If patients are sick, they need to come. The consultants are on the front line, and [patients] are going to get good, excellent care."
He said the majority of around 600 resident doctors in Christchurch were off work for the strike.
"I have not had one member say they are going to work."
Davis said the results of a union survey on fatigue showed the problem was widespread, and was the tipping point for members in their decision to strike.
"It really hit home that this isn't something that just happens on occasion, it's something that happens regularly.
"We all know these shifts have been in place for a long time, we all know they are hard work but it takes something like [the survey] to bring it light."
More complicated illness and injury, and an increase in treatments available had made the job much harder over the last decade, Davis said.
DOCTOR COVER - AT $300+ AN HOUR
Association of Salaried Medical Specialists executive director Ian Powell said his union's members - senior doctors - were being called in to cover the work as junior doctors were on strike.
The union had been wanting an increase on rates on what was paid in the last junior doctors' strike in 2008 to keep up with inflation.
But health boards had refused to budge, with some keeping the 2008 rate and others dropping it by up to 30 per cent.
The union wanted a typical hourly rate of $340 - up from $300 per hour in 2008 - but health boards were typically offering $200 to $300.
He accused health boards of a "belligerent" attitude that relied on senior doctors' good will.
"The DHBs know doctors will do the work."
MINISTER: DEMANDS WOULD MEAN 160 EXTRA DOCTORS
Health Minister Jonathan Coleman told RNZ doctors' demands would cost $60 million and require an extra 160 junior doctors.
The major issue between the striking junior doctors and DHBs was that they wanted to be paid for an extra two days off, he said.
Coleman agreed that if doctor and patient safety was at risk, something had to change.
"It is unacceptable if our junior doctors are working in unsafe conditions," he told RNZ.
However Coleman said the strike would not affect patient care, other than to delay non-urgent procedures.
"Anyone who has a life or limb emergency will get the best available care, there's no question about that," he said.
National Secretary of the NZRDA union Dr Deborah Powell disputed the $60 million figure.
"I think the Minister might have been mis-informed there. Those figures have never been discussed at negotiations."
She said both parties agreed the deal would require another 140 resident doctors at a cost of about $11m.
The union has suggested using medical graduates to make up the numbers, which Powell said are already subsidised by DHBs.
Any further gaps could be filled by temporary UK medical graduates.
AFTER HOURS CENTRES BRACE
In some DHBs, such as Canterbury, after-hours calls to GPs will be re-directed to a nurse for free health advice.
Non-urgent patients who turn up at ED will be asked to seek help from family, their GP or an after-hours medical clinic at some DHB hospitals.
After-hours medical centres are bracing themselves for a busy time.
David Jones, owner of Christchurch's Moorhouse Medical Centre, said he had not employed extra staff for the period as the resources were not available.
"To be honest we haven't made any additional preparations other than expecting that it's going to be a little busier."
It remains unclear how many union members will strike, but it could be up to 3000 across the country.
Senior doctors will fill in to care for acute patients in hospital while junior doctors stay home.
A strike notice was issued by the New Zealand Resident Doctors' Association (NZRDA) on October 3 after negotiations broke down with DHBs.
The union wants a maximum of 10 days worked in a row – down from 12 – and a reduction in night shifts from seven to four.
DHBs came under attack from the senior doctors' union yesterday over how much they were being offered for extra work done during the strike.
The Association of Salaried Medical Specialists (ASMS) represented about 90 per cent of senior doctors employed by DHBs, ASMS executive director Ian Powell said.
They were offered $180 to $500 per hour, in addition to their standard pay, for additional work done, Lakes District DHB chief executive Ron Dunham said.
The rate is the same as that given in 2008 during the last resident doctors' strike.
Dunham said the union rejected the offer late on Thursday and DHBs had to continue with contingency planning.
ASMS advised its 4000 members to demand between $340 and $568, as an increased rate was needed to account for inflation.
The departure from negotiations took the union by surprise, Powell said.
"This is unchartered territory and we've never experienced this before, but we've always been able to agree in advance on something."
Dunham said DHBs had to strike a balance between "providing safe care and prudent use of the taxpayer's money".
Other staff such as nurses would be affected but were not asking for extra payments, Dunham said.
The New Zealand Nurses Organisation (NZNO), a nurses union, said few tasks usually done by junior doctors would be within nurses' scope of practice.
"[Nurses] can't be doing the work of striking doctors," NZNO lead organiser Lesley Harry said.
Some nurses were taking annual leave as the drop in electives would make it quieter for them.
The last strike by junior doctors in New Zealand was in 2008 and Harry remembered it as "fairly quiet" for nurses.
WORK, STUDY, SLEEP
Powell said doctors would spend their 48 hours off work carrying out positive work in their communities, and catching up on study as well as sleep.
Striking doctors in Gisborne planned to spend the day planting a community garden near the hospital.
Other doctors would spend the two days teaching first aid.
While many of the junior doctors who were on strike would probably spend the days studying and sleeping, Powell said.