Hospitals facing Christmas crisis

Hospitals face "the worst ever" shortage of junior doctors heading into the holiday season, prompting new fears about patient safety.

Despite a fresh intake of graduates, the Auckland region has 36 vacancies for junior doctors, which means many of those employed will not be granted leave over Christmas.

Long hours, low wages and financial pressures from large student loans mean one in five are leaving the profession to work overseas - or are simply working as locums because the pay is better.

Auckland District Health Board clinical training director Dr Stephen Child described the staff shortages as "the worst ever" and "a major concern", not just in Auckland but nationwide.

Auckland had employed 27 per cent more junior doctors in the past five years while the medical school's output had increased only 4 per cent.

"Basically, demand is outstripping supply. And it is true internationally. It's a major problem for most countries," Dr Child said.

Doctors leaving the permanent workforce to become locums was a major issue for health boards, he said.

"It drives us crazy."

Dr Deborah Powell, general secretary of the Resident Doctors Association, agreed the situation was dire.

Many doctors were worn out, putting public safety at risk, she said.

"If we're too tired, what do we do? Do we go home or do we stay because there will be no one else to look after the patients?

"But we are not doing the patients a service by working when we are not fully functioning," she said.

The shortage was deeply concerning, especially at a time of the year when hospitals should have no job vacancies, she said.

"We are at changeover, when the medical schools graduate. So we have all the graduates on board," Dr Powell said. "From now on it goes downhill. By August, all hell will be breaking loose."

The junior doctor shortage had been building for years and was now close to crisis point, she added.

Junior doctors were leaving the permanent workforce to become locums because of the better conditions, creating vacancies others were then paid more to fill.

Dr Child said part of the problem lay with the rigid clauses of the doctors' collective contract.

The answer was to allow different departments and hospitals to have different solutions instead of one contract with one set of conditions covering everybody.

- HERALD ON SUNDAY