Health minister warned first-hand by doctors about impact of staffing shortages on patients

Friday, 20 September 2024

Tova O’Brien is Stuff’s Chief Political Correspondent and host of the political podcast, Tova. Listen to the latest episode ‘Goldsmith on gangs’ which includes the interview with junior doctor Emma Littlehales, here.

The health minister has been warned first-hand by junior doctors that staffing shortages are impacting on their health and wellbeing, and patient care is suffering.

Junior doctors met with Minister Shane Reti on Thursday and presented survey results which paint a grim picture of the state of frontline health care as a result of a hiring freeze and staff vacancies.

“People will leave because burnout is a real problem in the healthcare profession,” Emma Littlehales told the Tova podcast. She’s a plastic surgeon trainee and senior executive at STONZ, the union representing half the junior doctor workforce.

Littlehales was among those who met with the minister and says doctors won’t put up with the conditions in New Zealand for long, “they’ll go overseas, they’ll go to places where they can get paid better and are more well looked after”.

Some could be driven from the profession entirely, “they’ll go and they’ll leave medicine. We know that people are thinking of leaving medicine entirely and that’s sort of the future of the health force that you’ve got there.”

Health NZ-Te Whatu Ora insists it’s made “great progress” in growing the clinical workforce but acknowledges there are some regions and specialist areas with gaps.

“Ensuring we have enough doctors, nurses and allied health professionals on the frontline is a top priority for Health New Zealand,” Health NZ’s Chief People Officer, Andrew Slater, told Stuff.

But according to results from a survey of more than 700 STONZ members, the shortages are widespread.

More than 80% of junior doctors who took the survey have seen resources reduced.

Budget restraints and the recruitment freeze have meant they’re spending more time doing paperwork, more administrative tasks, there are delays getting training reimbursements and delays getting paid for additional duties or shifts.

One junior doctor quoted anonymously in the survey said: “Delays in reimbursements have meant being overdrawn or late on payments for childcare and/or mortgage this year.”

Littlehales agreed, “People give up their time with their families because there are so many gaps in the roster, and then because of the lack of back office staff, they’re then having to spend months waiting to be paid for doing those duties.”

More than 50% of respondents said there are permanent vacancies for junior doctors in their service - half also said there are senior doctor vacancies.

There’s one question in the survey that paints a particularly vivid picture of the personal, professional and practical effects being felt by junior doctors.

More than two thirds said the staff shortages are impacting their work in one or more ways.

76%, that’s 373 doctors, say the shortages are affecting their ability to provide good patient care and half say they’re impacting their health and wellbeing.

Half of all respondents are also completing work which normally wouldn’t be theirs, 38% say it’s affecting their ability to access their leave, 43% say it’s impacting their access to training.

In terms of how it’s affecting patients, 42% say they are working on acute patients only, 39% have had to cancel theatre lists and 29% have cancelled clinics.

“It’s manifesting in delays. We’re seeing delays in patients getting to theatre, delays in patients being seen for their follow up clinic and then we're also seeing a real lack of morale,” said Littlehales.

Doctors told the minister that losing back office roles meant other staff weren’t being paid correctly or on time.

Littlehales said Reti gave some assurances that he would look into the effect back office cuts were having in terms of payroll and support for the frontline but that concerns they raised about the hiring freeze causing gaps and meaning doctors were unable to effectively do their jobs and care for patients didn’t match up with the numbers the Government said it had recruited.

Between June 2023 and June 2024, Health NZ says its clinical workforce grew by 4107 Full-Time Equivalents (FTEs), including 158 junior doctors.

It says in July, 1010 offers of employment were made and accepted, including 71 junior doctors.

Asked who the public should believe given the conflicting pictures being painted by Health NZ and the frontline, Littlehales said:

“I mean, it’s difficult, but we’re the people on the ground that see it. Obviously, you know Margie Apa, they have a higher level view, but they’re not there day in, day out, actually seeing the effect that it's having, seeing the gaps in person.”

Reti was approached for an interview but declined.