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Senior Doctor Advice Over Coping With Drs. Strike



"Senior doctors in public hospitals need to disabuse hospital managers of any suggestion that they can fill the gaps left by striking junior (resident) doctors,” said Mr Ian Powell, Executive Director of the Association of Salaried Medical Specialists, today. Mr Powell was commenting on a letter sent to senior doctors by National President Dr Peter Roberts last week.
“Other key elements of this advice include:
 Senior doctors should make it absolutely clear to management the range and level of services that can be safely provided and equally so what must be cancelled.
 The more services senior doctors struggle to provide, the longer the strike might continue and the greater the risk to patient safety.
 The key moral duty for senior doctors is to maintain emergency cover during the strike.”
“Senior doctors are the meat in the sandwich of an industrial dispute that they are not party to. In the interests of patient safety and fairness the sooner the recruitment and retention issues responsible for this dispute are sorted out the better,” concluded Mr Powell.

Ian Powell
For further information please contact:
04 499.1271 work 021 445.521 cellphone

Attached... Letter...

17 August 2000 6/5

Dear Colleague

RMO’s Industrial Action

The Resident Doctors Association (RDA) is currently involved in difficult contract negotiations on behalf of their members with Hospital and Health Services (HHS) throughout the country. There are two sets of negotiations, one with the three Auckland HHS and the other with all other HHS employers. Strike notices have already been issued to at least five employers and others are expected any day.
The RDA has advised us that they expect their members in other centres to vote for strike action over the course of the next few weeks. Dr Deborah Sidebotham, General Secretary of the RDA has also advised us to expect a series of weeklong strikes throughout the country until a settlement is reached. It is likely that the strikes will coincide with one another and the country may well be faced with a total national strike of RMOs.
The negotiations are aggravated by a serious RMO shortage. The reasons behind the shortage are numerous but have been aggravated by the high level of student debt and the superior conditions of employment overseas, particularly in Australia. Australia has aggressively reduced RMO working hours, thereby producing their own shortages. The Australian RMO shortage, coupled with better hours and substantially higher remuneration, is an irresistible lure for RMOs facing years of student debt repayment.
If these strikes go ahead our hospitals will not be able to cope. My purpose in writing to you is to offer the Association’s support and advice as you struggle to provide what care you can for the sickest patients who may need urgent hospital treatment during the strikes.
Perhaps the most important advice we can offer is that you and your colleagues should immediately disabuse management of any notion that senior doctors and nurses can fill the gaps left by striking RMOs. That is simply impossible. Normal services cannot be provided and should not be attempted. In many specialties senior medical staff function has already been compromised by RMO and consultant shortages.
Our next advice is that you and your colleagues, department by department and through your senior medical staff group, should prepare and submit to the chief executive a clear statement of the range and level of services you can safely provide. This statement should be unequivocal as to what services will be cancelled and what limited services will be maintained.
However you should be aware that the more RMO gaps you and your colleagues try to fill and the more services you struggle to provide, the longer the strike will continue. Attempts to cover for striking RMOs in the interests of patient safety may create more risks for the patients you seek to help, by prolonging the strike and delaying a return to “normal” services. We have no legal or moral responsibility to try to maintain services as if there were no RMO strike; our duty is simply limited to maintaining emergency cover until the strike is over.
In the absence of RMOs, work should be undertaken only if it is both safe and necessary to perform without RMOs. We must not compromise patient safety by using less well trained staff or by attempting to do the work ourselves. In a legal sense, an RMO strike is not an unavoidable emergency that might excuse a lower standard of care. These strikes were foreseeable, have been well heralded and are even now avoidable.
It is right that any additional work performed under strike conditions should attract additional payment. I urge you to contact the national office for further advice in this regard. If you have concerns of a medico-legal nature you should seek the advice of the Medical Protection Society.
We must all hope that this crisis will soon pass without harm to our patients, our colleagues, our own health or our profession. Good luck, we will all need it.

Yours sincerely

Peter Roberts

In 1995 the ASMS National Conference adopted guidelines: Advice to Members when other Health Employees are on Strike or take other forms of Industrial Action.
They are available in our member’s blue ASMS Handbook: Including Rules and are also available on our website at
I encourage all members to read these guidelines and use them when formulating a response to these RMO strikes.

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