7. Hon TONY RYALL (National—Bay of Plenty) Link to this
to the Minister of Health
Has he received any reports about a data request being distributed to district health boards seeking confirmation of the number of junior doctor positions for a recruitment programme in the United Kingdom; if so, what was the estimated demand for junior doctor positions indicated by the 14 district health boards who responded?
Hon PETE HODGSON (Minister of Health) Link to this
Yes, I have. The approximate vacancy rate for junior doctors in New Zealand is about 5 percent. Most of those vacancies are filled on a day-to-day basis by locums. Given that there are about 2,800 junior doctor positions in New Zealand, 5 percent represents about 150 positions.
Has the Minister seen this second leaked document from District Health Boards New Zealand, which makes it clear that recruitment will be sought in Britain for over 250,000 vacancies; and if there is no staffing crisis amongst junior doctors, why are district health board representatives going urgently to London to recruit these additional staff?
I think even the member exceeded himself when he said that district health boards were going to the United Kingdom to try to find 250,000 doctors. He might have meant 250.
Simon PowerOK. Well, if he meant 250, what he has done is add in the registrars as well, and the vacancy rate for registrars is less than 5 percent. Mr Ryall can try to beat up a storm as hard as he can, but he should get his figures right.
I seek leave to table a quote from the leaked document today: “In brief, there is an estimated demand to fill a total of 238 junior doctor positions.”
Madam SPEAKER
Lesley SoperDoes New Zealand have a 5 percent vacancy rate in junior doctor positions because there is a reduction in junior doctors available to work, or because the health system is growing and creating new junior doctor positions?
That is a pretty good question, and the answer is the latter. It is because our health system is growing. We have employed 1,400 more doctors since the change of Government and we want to employ about 140 more residential doctors—about 140 more. In the short term, those vacancies of 140 will be filled by new graduates when they come out in November or December, and there are about 285 of those each year; by junior doctors recruited from Britain, and the district health board representatives are leaving for Britain on Monday; or by junior doctors who are working in New Zealand at the moment but are currently choosing to work as locums because they get better pay.
Why is the Government so willing to throw money at recruiting temporary staff from overseas, while at the same time it is refusing to take any initiative to retain our own people in permanent district health board employment?
I think it is probably worthwhile pointing out that today—the day when the member decides to try to beat up a crisis—is the day that the junior medical industrial relations talks begin. Let us make sure that industrial relations discussions are not a very common feature of this Parliament.
Dr Jonathan Coleman Link to this
Does the Minister believe that the quality of health care in public hospitals has improved during his reign; if so, does he also believe that patients are better off when they are treated by half a dozen different doctors during a 3-day stay in hospital, which is the reality for many of our sick, elderly patients; and is he so spaced out and out of touch that he does not understand that registrars are actually junior doctors?
I understand what a junior doctor is, but I also understand we do not need 250,000 of them. As to the number of doctors who are seen by a patient, I think that the member is assuming that a locum is a short-term position only. He should take a look at the facts. Locums often operate in a hospital, on their shift work, for a long period of time. There is actually a market for locums, and the market for locums is a little expensive for district health boards, which is one of the reasons why they are going to Britain.
Heather RoyIs the real problem that the Government has increased health spending by a whopping $4.5 billion a year, with the only tangible result being that there are now more health bureaucrats than there are hospital beds, and is the Minister not embarrassed that this proliferation of pen-pushers has been at the expense of junior doctors and others at the coalface actually treating patients?
I have a trick question for the member. Does the member think that the number of managers in our health system is 8 percent, 6 percent, or 4 percent?
The question was about bureaucrats, and I am asking whether the number of managers is 8, 6 or 4 percent. The answer is 3 percent. Three percent of our district health board staff are managers; 97 percent of our district health board staff are not managers. The member trots out the fact that there are too many bureaucrats around—3 percent ain’t bad.
Dr Jonathan Coleman Link to this
Does he agree with me that it is not acceptable for spending on hospital locums to double in 6 years to over $100 million, and does not this reliance on temporary staff show that working in a district health board is not an attractive career option because for every new doctor employed, district health boards employ another bureaucrat to keep an eye on that doctor?
I do think the number of medical locums in New Zealand is too high. I agree with the member, and I look forward to the situation arising where we have sufficient junior docs to be able to reduce, at least somewhat, the locum market. As to the allegation that for every doctor we employ we employ a bureaucrat, I am not sure what bureaucrat the member refers to. It might be the bureaucrat who answers the phone, it might be the bureaucrat who arranges for the pay, it might be the bureaucrat who decides how the out-patient clinics will be put together, or it might be the bureaucrat who keeps the medical records safe. Which of those bureaucrats would he not have?
As the Minister has finally admitted that the number of locums working in our hospitals is a concern to the Government, does the Minister agree with me that the skills and expertise of some locums can be variable, the locums are not subject to ongoing performance review or training, and their working hours are not monitored; and surely this must have an impact on the quality and continuity of care that particularly our older patients are experiencing in New Zealand’s public hospitals?
Far from finally admitting that locum—[ Interruption] The member may not know everything that I think or say. The member is not actually omnipresent. The member did not hear me talk at a workforce conference, just this morning.
Please be seated. The member has invited, through his question, an answer from the Minister. Would he please allow the Minister to respond.
Thank you, Madam Speaker. There is nothing new for me in saying the locum market is growing too quickly. It has been growing for some years. It is an important part of the health system, because it allows for flexibility. But my view is that it is getting a little large. As to the quality of locums, I think the member needs to be quite careful. If the member is going to assert that locum doctors are of poorer quality or subjected to less auditing, he needs to come up with the evidence, because the Medical Council would be unlikely to agree with him, and the doctors with whom they work would be unlikely to agree with him.