Health unions balk at staffing plans

By MARTIN JOHNSTON health reporter

Plans to replace some junior doctors with nurses and employ more low-paid healthcare assistants are worrying health unions.

The Auckland District Health Board wants to double the number of healthcare assistants it employs to 160 within two years.

Last week, chairman Wayne Brown expressed support for the role of nurse practitioner, highly trained staff of whom there are only six so far in New Zealand.

"I want these people out there doing what junior doctors are doing," he said.

Mr Brown wants his $870 million-a-year organisation to cut jobs to achieve the promised $40 million annual savings from shifting into its new, more efficient hospital this year and next.

While the number of hospital beds will decline by 7 per cent, compensation will come from some services shifting to the region's other two boards and more treatment being done without the need of an overnight stay.

The Auckland board, which employs the fulltime equivalent of 7000 staff, intends to shed 250 clinical and administrative positions within a year.

Healthcare assistants - formerly orderlies, nurse aides and others who help clinical staff - are paid less than $30,000 a year.

Most nurses earn between $30,000 and $44,400 before overtime. In senior clinical roles some earn up to $60,000 - more than some junior doctors.

The Auckland board's director of nursing and midwifery, Taima Campbell, said healthcare assistants would not replace nurses. They would help nurses, doctors and other health workers.

"They won't do things outside the scope of their practice [which would be] anything requiring diagnostic inquiry or decision-making, in terms of patient care."

A Nurses Organisation manager, Laila Harre, expressed concern at the planned increase in healthcare assistant numbers.

The union was developing a project with the Health Ministry to assess minimum nurse/patient ratios.

"We would be really concerned at any structural changes made in the allocation of work between different nursing staff, including healthcare assistants, ahead of a proper examination of appropriate registered nurse staffing levels," she said.

Previously the union has tagged the use of healthcare assistants as often unsafe, saying some hospitals allow them to do clinical work.

Ms Harre said Mr Brown's comments about junior doctors were a divide-and-rule tactic.

Resident Doctors Association general secretary Deborah Powell said junior doctors and senior nurses worked alongside each other and were both vital.

"Wayne Brown has made unhelpful comments about residents [junior doctors] before."