Staff cuts raise fears for sick newborns

By MARTIN JOHNSTON health reporter

The number of doctors caring for many of New Zealand's tiniest and sickest babies is to be cut under a plan criticised as unsafe by a union.

The scheme at National Women's Hospital in Auckland has infuriated the Resident Doctors Association, which has hinted at possible court or strike action.

But the hospital last night rejected the association's claim that the staff reduction in the neonatal intensive care unit would make it unsafe.

The 59-cot unit, which cares for sick and premature newborns, was last night overloaded with 63 babies.

The hospital's money-saving move would reduce by three the number of house surgeons in the unit.

They are paid about $58,000 a year.

But the association says the critical part of the cuts, to take effect next month, will be at night, when the unit will one junior doctor down on present staffing.

Currently there are three night staff: either three junior doctors, or two plus a nurse practitioner.

From next month, there will be two: a junior doctor, who will be a trainee specialist, and a nurse practitioner.

The association's general secretary, Deborah Powell, said members believed there would be insufficient staff on at night to provide a safe service if several babies needed treatment at once.

"The consultants are available on call but are up to 20 minutes away. With one of these wee babies being born you don't have 20 minutes."

But the hospital's clinical leader, Dr David Knight, said safety would be unaffected by the cuts.

"We have no concerns about safety. We wouldn't do it if we did."

The Paediatric Society's president, Dr Nick Baker, agreed.

Dr Knight acknowledged the cuts would save money - the Government has ordered the Auckland District Health Board, which runs the hospital, to cut $25 million off its $86 million deficit - but said this was not the main reason. Overstaffing was.

The workload in neonatal units had reduced with improved technology and a trend towards less intervention.

One of the three night staff was usually without sufficient work. Often one slept "for a considerable period" and the others were able to cope with the workload.

With the shortage of junior doctors, the three positions could be used elsewhere.

He said other hospitals coped with a higher ratio of cots to staff than National Women's present night rate of 19.7 to one.

Waikato Hospital's neonatal intensive care unit had 26 cots and one staff member on duty at night.

The planned cuts have raised tensions over negotiations to establish a national employment agreement covering junior doctors at the 21 district health boards.

Dr Powell said the cuts were being imposed unilaterally by the Auckland board.

She said they were contrary to the existing collective contract, which would expire this month, a view disputed by the board.

When asked if court action was possible, she said: "It may head for worse than that because we're in contract negotiations at the moment."

She agreed that the hospital's move heightened the risk of industrial action.

nzherald.co.nz/hospitals