US doctor feels heat from 'tense' dispute

Dr Chris Landrigan says New Zealand junior doctors are not overworked compared with their US counterparts. Picture / Greg Bowker

An American expert on how sleep deprivation can increase doctors' mistakes has been brought to New Zealand by employers in the middle of "extremely tense" talks with unionists.

District health boards, negotiating a new deal with junior doctors, have flown in Harvard University's Dr Christopher Landrigan to advise on safe working hours.

Promoting his visit, one board representative said he could "put into perspective the claim that our docs are overworked - the reality is that we have some of the most generous conditions in the world and that the only way to reduce total working hours is more flexibility in the workplace".

These comments incensed Resident Doctors Association general secretary Deborah Powell.

"This is the DHBs positioning themselves during what are turning out to be extremely tense negotiations," she said yesterday.

But the Auckland board's director of clinical training, Dr Stephen Child, dismissed her objections. He said Dr Landrigan's visit was neither provocative nor anti-union. It was part of the employers' process, started in 2004, of setting safety standards.

Dr Landrigan himself declined to discuss flexibility while the pay talks were on. When asked if New Zealand's 2800 house surgeons and registrars were overworked, he said they were not compared with US counterparts.

His research has shown that US junior doctors regularly working shifts of at least 24 hours made 36 per cent more serious medical errors than when they worked shorter weeks that excluded the "extended" shifts.

Four out of 10 New Zealand junior doctors in a survey reported they had made a medical error due to fatigue.

US junior doctors work some of the longest hours in the world - maximums of 80 hours a week and 30 hours in a row. In Europe, the target is 48 hours a week by 2009.

In New Zealand, the collective agreement sets 72 hours as the weekly maximum, although the average number of hours worked is around 57.

Because of findings like Dr Landrigan's on the risks for patients and the effect on doctors' personal lives, the union wants improvements.

A trial at the Northland and Waitemata health boards has reduced the number of consecutive days junior doctors can work from 12 to 10 and night shifts are limited to four in a row instead of seven.

Dr Powell said the trial was a success and no extra staff were required.

Dr Child said the trial had worked well but the changed rosters meant more staff were needed.

Extending the trial rosters to the 21 DHBs would require an extra 80 to 120 junior doctors, in a system already short of 110-120.