Junior doctors to enter their fourth and longest strike yet

Junior doctor at Tauranga Hospital Dr Ralston D'Souza. Photo / Supplied

Junior doctors across the country will walk off the job on Monday for their fourth and longest strike this year.

The five-day-strike was over a failure by both the New Zealand Resident Doctors Association and the 20 district health boards to agree on proposed changes to the doctors' employment contract.

The strike covers all DHBs across the country except Canterbury, where the hospital remains under pressure from the March 15 shootings.

The main problem is that district health boards want hospital chief executives to have the final say over working arrangements, rosters and hours rather than the union head office.

There are 192 junior doctors employed by the Bay of Plenty DHB. Not all are association members.

More than 1000 appointments and surgeries were postponed at Tauranga and Whakatāne hospitals during the three junior doctors' strikes that have already taken place this year.

Tauranga Hospital junior doctor Dr Ralston D'Souza said the dispute was ongoing and centred a lot around the DHB wanting full control over their hours and work conditions.

The current rules were that junior doctors were not supposed to work more than 16 hours a day and more than 10 days in a row. However, the DHB was pushing to have full control of hours and rosters that could essentially chuck out these rules, he said.

The spokesman for the DHBs, Dr Peter Bramley, said DHBs were not looking to reduce conditions or increase work hours.

However, the current system had a range of unintended consequences on patient care and training, and they needed to work with junior doctors to develop local solutions. They could not do that while the national union had power over work rosters, he said.

D'Souza said the issue as a junior doctor was standing up and say no would flag them as "troublemakers" to their employers.

D'Souza said the junior doctors wanted to "preserve our ability to keep our voice".

Because junior doctors needed that first two years of training, he said they were already in a vulnerable position and it was difficult to stand up for themselves.

With the current 10-day stretch, he said doctors would work 15-hour days on weekends then get a break. However, if the new rules were brought in this could change.

The long hours and stretches could impact a junior doctor's ability to be "emotionally connected" with their patients, which D'Souza believed was important.

"Coming into hospital can be a big and scary thing for a person and we want to be able to be the best we can be for them, not burnt out."

D'Souza said Tauranga Hospital rostering was a bit better than other DHBs around the country.

Bramley said the proposal still gave the union the power of veto over decisions made at a local level and with 70,000 people working in the health sector, no other union had that control.

One DHB option was a dedicated ombudsman-type role within each DHB to address roster disagreements or issues, but the union rejected it as a possible solution to this dispute, he said.

Bay of Plenty DHB acting chief executive Dr Hugh Lees said in order to cope with the strikes, the board would re-arrange services such as deferring some non-urgent procedures, and outpatients appointments to free-up senior doctors.

The DHB would not know how many doctors were taking strike action until the start of each shift, he said.

The Tauranga junior doctors will not be picketing, but instead planned to hold education sessions around the city for various social agencies throughout the week.

Facilitation for the dispute has been set down for the May 9, 10, 13 and 14.

The DHB asked people to only come to the hospital emergency departments for emergencies and to contact their GP or Healthline if they require medical attention that was not life-threatening during the five-day strike.

Patients who have had their appointments postponed will have been contacted by DHB staff.