Doctors' 80-hour weeks 'unsafe'

Public hospitals' heavy reliance on employing casual doctors is inducing some to work excessively long and "unsafe" hours, a state sector inquiry has heard.

Submissions suggest some newly graduated to mid-grade doctors may be working 80 hours a week by doing casual shifts in addition to regular hours which, for a permanent employee, are typically 55 to 60 a week.

The Ministry of Health last year appointed former State Services Commissioner Don Hunn to head a Commission on the Resident Medical Officer Workforce.

The commission's report on RMOs - house officers and registrars - is expected to be made public within weeks but its summary of the submissions has been placed on the ministry's website. Submitters included district health boards, medical unions and the Medical Association.

The summary says district health boards, mostly struggling to employ sufficient permanent RMOs, are increasingly dependent on what they call "expensive professional locums".

"Submitters noted that...a shortage of RMOs makes employers seeking locum cover reluctant to ask how many hours a potential locum has worked that day or week.

"Submitters reported unsafe practices where RMOs work in excess of 80 hours a week, locuming on top of regular hours."

"Locums are generally regarded as being poorly supported and supervised with tenuous ties to any training they may nominally be involved in."

The commission says some blamed the collective agreement between the DHBs and the Resident Doctors Association for the long locum hours because compliance meant RMOs were rostered to work no more than 55 hours a week on average.

This "creates shortfalls" of permanent RMOs, "which are then filled by locum agencies", the commission was told by an unnamed submitter.

The Resident Doctors Association says the worst shortages of RMOs remain in Auckland.

The Waitemata District Health Board continues to suffer "extremely challenging" shortages in its general medical service, papers for a committee meeting this week say.

Vacancy rates have hit 42 per cent for house officers and 33 per cent for registrars.

Association secretary Deborah Powell said the main cause of the resident doctor shortage was that DHBs could not retain enough because they did not pay pay enough.

PAY RATES

Base annual city salaries for 55-to-60-hour week:
* Graduate doctors: $76,328
* Senior trainee specialist: $130,487

Auckland locum hourly rates:
* House officers: $60-$120
* Trainee specialists: $75-$150
* The top rates are for Friday, Saturday and Sunday nights.