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Staff shortages, financial constraints bite public hospitals

26 March 2014

Staff shortages and financial constraints biting public hospitals

“Staff shortages and financial constraints are clearly starting to bite at some public hospitals,” said Mr Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS), today.

“Last week we heard about drastic cost-cutting plans and possible job losses at Auckland DHB as it grapples with both a deficit and increasing pressure on its services,” he says.

“We’ve also heard in the past few days about Southern DHB’s battle to deal with a $13 million deficit – and now we get the news that four district health boards have been identified as at risk of staffing shortages. This is the last thing patients and the already stretched clinical workforce needs to hear.”

The Waikato Times has reported that four DHBs – Waikato, Hawke’s Bay, Hutt Valley and Nelson Marlborough – were found to be at high risk of staffing shortages in specific staffing areas during routine certification audits last year. Health Minister Tony Ryall told Labour health spokesperson Annette King in a written answer that the Ministry of Health had since downgraded their risk level to moderate.

“But what does moderate mean when it comes to being short of front line clinical health staff?” asked Mr Powell. “These shortages might seem moderate to the Health Ministry but I bet they’re not regarded that way by either the public or the doctors and nurses who have to deal with the day to day reality of too few people on the hospital wards.”

Mr Powell says DHBs around the country have signalled to the ASMS that they are increasingly strapped for cash and something will have to give. Waikato DHB, for example, has indicated it is looking for $40 million in savings in 2014-15 and will need to change the way it does some things.

“The risk is that some DHBs, like Auckland, will reach for panic solutions which offer immediate financial relief, even though these solutions may have longer-term consequences for the provision of health services, quality of care, and the clinical workforce. This would be extremely unwise but in reality it reflects the broader issues of political under-investment in health care and the clinical workforce, which the Government needs to take responsibility for.”

Mr Powell says entrenched shortages of hospital specialists have been the norm in New Zealand for years. The solution is greater investment in the workforce, more realistic funding for DHBs to meet the actual costs of running a national health system, and to stop placing unrealistic expectations on DHBs which then put unwarranted pressure on services.

“We know DHBs are making valiant efforts to stay in the black but the message we’re getting loud and clear is that they’re fast running out of money, and that this is making things tougher for the professional, skilled clinical workforce that holds New Zealand’s health system together.”

Mr Powell says an additional concern is the progress of the Employment Relations Amendment Bill, which has just had its second reading and is on track to pass into law. If it does, he says it has the potential to cause significant stress in the health sector by removing a number of important protections for the clinical workforce.

“Under the current Employment Relations Act, senior doctors are assured of nationally consistent entitlements across the DHBs in terms of salaries, professional development, annual leave and the right to take part in public discussion of health. Those things are at risk if this punitive new piece of legislation becomes law,” concluded Mr Powell.


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