7. Hon TONY RYALL (National—Bay of Plenty) Link to this
to the Minister of Health
What is the estimated house officer vacancy rate for each of the three Auckland district health boards for the third quarter, which starts later this month, and does he expect the vacancy rates to worsen?
Hon JIM ANDERTON (Acting Minister of Health) Link to this
I am informed that the three Auckland district health boards have house officer vacancies—interpreted by most people as meaning a shortage of doctors—estimated at less than 2 percent, which represents seven doctors over three district health boards. I am also advised that it is not expected that the overall shortage will worsen in the next quarter.
How seriously is the Government taking this issue, when senior clinicians from hospitals in Auckland are talking about a 21 percent shortage in Auckland and a 28 percent shortage in Waitematā, when the country is facing a worsening shortage of hospital doctors, and when the New Zealand Minister of Health, Pete Hodgson, is in Wales, advising the Labour Party there on how to form a new Government—just as his own is falling apart?
This Government is the first Government since 1981 to increase the number of doctors trained—an increase of 40 since 2004. Also—[ Interruption]
Madam SPEAKERMr Ryall does not seem to understand that the doctors are there. In many cases, they are taking up locum positions so they can be employed on better pay and with better conditions—and why would they not? So there is not actually a shortage of doctors. Dr Stephen Child, the director of clinical training at the Auckland District Health Board, said on Morning Report this morning: “Most importantly is we need to look at how we currently staff our hospitals. We have what is called fixed staffing ratios, which means we have to have so many doctors on during the daytime rather than being able to roster doctors when we need them. And I think we need to look at the way we do the whole system and try to do things a bit smarter.” I would say “amen” to that.
Maryan StreetHas the Minister heard any reports of compromise to patient safety in respect of junior doctors in the Auckland area?
I heard that, not unusually, Mr Ryall on the radio this morning was luxuriating in some unnecessarily worrying and scaremongering statements. He said: “The real worry for Aucklanders is that unless these shortages can be fixed, their services will be affected.” But in the same news item two senior clinicians in Auckland agreed that there will be no compromise in patient safety. I am also informed that there are no plans to cut back on elective surgical services as a result of any potential house officer shortages. I advise Mr Ryall to stop being an ambulance chaser in this House and around the country.
Barbara StewartIs the Minister concerned that the increased rate of locum use at Auckland hospitals is exacerbating doctor shortages, as more are opting out of regular positions to take up better-paying locum work; if so, what is he doing to improve the situation?
As I said, that does not equate with doctor shortages; it means that many of these positions are being filled by locums on better pay and conditions. I note that the medical education and training report, launched last week by Dr Cullen and Mr Hodgson, states that following the first post-graduate year there is no specific clinical requirement for the second post-graduate year, and many doctors decide to make what amount to lifestyle choices and become locums. This is clearly an area of the training system that needs further consideration; I understand that it is being done as a matter of urgency.
When will the Minister of Health, Mr Hodgson, return from Wales, where he is giving the Government there advice on how to form a new Government; and does the shortage of doctors mean that services in the greater Auckland area will have to be changed in the way they are configured—for example, will women in the Waitematā District Health Board area have to deliver their babies at Auckland City Hospital because of the shortage of obstetric registrars on the North Shore?
I do not think that Mr Hodgson will be returning any time soon in answer to any pressure that Mr Ryall puts on him. I do not know exactly what the situation will be for obstetrics. If the member wants a specific answer to that question, he can submit it to me and I will see that he gets it.
Does the Minister think that Dr Pat Alley, the training director of Waitematā District Health Board, was lying when he said that hospitals in the Auckland region are facing the highest staff shortages ever seen; and does it not show that after 8 years, 43 reports, and numerous committees on the health workforce, this Government has absolutely no idea of what is going on?
What I do know is that Dr Pat Alley said on the radio this morning that he is absolutely convinced there is no compromise in patient safety because of so-called staff shortages. Dr Stephen Child, the clinical director, agrees. He says Aucklanders should be reassured that there are still a large number of doctors who are able to fill the gaps. However, Dr Child says that in the long term, staff retention and recruitment processes must be addressed, and he concedes that a better approach is needed. It would be much better for the confidence that anyone might have in an absent National Party health strategy for Mr Ryall to start dealing objectively with these matters.
Does the Minister think it is an acceptable quality of care for New Zealand patients when even Dr Child from the Auckland District Health Board admits that patients see one locum doctor one night and then another locum doctor the next night, and is it little wonder that there are so many problems in the public health system when doctors change more frequently than the bed linen?
I think that members of the House might just reflect on that description. It goes to the heart of the credibility of the member who said it. In fact, the reality is that, as I said, the medical education and training report launched last week by Mr Hodgson and Mr Cullen indicates that there are necessary changes to be made in the system—not that there are shortages of doctors, as Mr Ryall shouted out on breakfast radio this morning, but that the way in which the doctors are actually used and resourced needs to be improved.
I seek leave to table a report that shows Pete Hodgson in Wales—while hospitals are facing record doctor shortages—advising the Labour Party there on how to form a new Government.