JUST over 3,200 of New Zealand’s 3,500 junior doctors began 48-hour strike action at 7.00am yesterday morning.
The New Zealand Resident Doctors Association (NZRDA) members are fighting to restrict the number of consecutive days they are obliged to work. Their union wants the maximum number of days junior doctors have to work in a row cut from 12 to 10, and the number of night shifts worked reduced from seven to four.
Many of New Zealand’s junior doctors have complained that they’re often worn out from working long hours, and say that the safety of their patients is at risk. National Secretary of the NZRDA, Dr Deborah Powell, said on Monday: ‘I’m surprised it’s got to a strike, this (current rostering) is a significant health and safety issue, I honestly didn’t think it would get to this point.
‘After four years of trying to get this sorted we simply don’t trust the DHBs’ (District Health Boards) commitment to the issue. We want it confirmed in a contract so that it is legally binding,’ she added.
If the current situation continues then New Zealand could face a similar situation to that of Britain’s National Health Service (NHS), where the Tory government is now imposing new inferior contracts on junior doctors which their union the BMA describes as both ‘unsafe’ and ‘unfair’.
New Zealand’s junior doctors graduate with a student loan debt that in most cases is up to $100,000. They then enter the workforce and are expected to work 60 hours a week, but many end up working 72 hours a week and 12 days in a row without a break. This initial strike could lead to others and further disruption, if the concerns of junior doctors aren’t acted upon.
Dr Deborah Powell declared that they are not demanding a pay rise and that a commitment to fewer hours from DHBs isn’t enough – they want it to be a contractual obligation.
‘We’ve been working on this for four years now and had only limited success so at this point and time we want a contractual obligation that these hours will drop. Resident doctors are on a salary, that salary is tied to the number of hours they work in a week on average, and it’s done in five hourly blocks so they get a salary if they work between 55 and 60 hours, or between 60 and 65 hours a week. If their hours of work drop outside one of those five hour blocks then their salary drops along with it.’
Dr Powell added: ‘The DHBs want two years to implement this – we think that’s unnecessarily long.’
She added: ‘We also want to sort out recuperation time after these long stretches of work. We need to make sure doctors have meaningful rest and recuperation before they come back to work, and the DHBs haven’t come to the party on that one yet.’
Dr Shobna Singh works 12 days in a row with a two-day break in between, and spends her days and nights treating patients for up to 14 hours a day at Auckland’s North Shore Hospital.
‘At this point I feel delirious,’ she said at the end of a 14 hour shift, on day 11 of a 12 day shift last week. Those two days off recharge you enough to keep plodding, barely, but that’s not enough to be a great or even decent doctor. Right now I’m pretty apathetic,’ she said.
Second year resident doctor Emily Shine, 25, said that doctors build up stamina for the long days – ‘but doing them again and again is what wears you out. The way you interact with patients changes, and you miss things like dropped blood pressure or allergies. They affect what dosage you prescribe and you just don’t notice these things when you’re tired.’
Exhausted Bay of Plenty doctors say gruelling rosters are putting patient safety at risk, as they work 12 days straight and up to 16 hours a day. A recent survey by the Resident Doctors Association found 1,162 doctors had reported being so fatigued from working long hours they were worried they had made a clinical mistake.
The survey also found 275 doctors had fallen asleep driving home after working those particular rosters. House officer Dr Ash Ellis said patients are often ‘surprised and shocked’ when they learn the hours doctors are expected to work. They ask: “How is that allowed? I thought that would be illegal? I thought health and safety would have something to say about that”?’
In two of the seven rosters at Tauranga hospital, resident doctors work up to 12 days in a row, which includes some 16-hour day shifts, and up to seven consecutive 10-hour night shifts.
He said patient safety could be compromised when doctors are suffering from fatigue. He said workmates at the end of 12-day shifts are so tired they are ‘desperate to get out of hospital.’
New Zealand Nurses Organisation industrial adviser for the DHB sector Lesley Harry said the district health boards need to take doctors’ concerns seriously. ‘This is a major red-flag safety alert for doctors and their patients,’ she said.
‘Nurses can testify that what doctors are saying about short staffing and burnout is a fact. I think the public don’t want to have that person treating their loved ones in a life-or-death situation.’
Fourth-year Dr Katie Griggs, 27, described shift patterns as ‘punishing’, adding that she is currently on reduced hours because she’s pregnant but warning that the 12-day stretches leave doctors ‘fatigued and grumpy.
‘I feel concerned about my ability to make safe decisions,’ she said. ‘It’s much more likely you’ll make a prescribing error when your brain is tired and it’s easy to miss small details. In medicine it’s the small details that really make the difference.’
• New Zealand’s Unite Union has accused McDonald’s and Burger King of trying to cheat their staff out of their rights under both the collective agreements and the law and says it is taking both companies to court.
On Monday, Restaurant Brands and Unite Union amended their collective agreement to put an end to ‘zero hours’ contracts at KFC, Pizza Hutt, Starbucks and Carls Jr. The fast food chains had been criticised for signing workers up to agreements that do not guarantee any hours.
Unite Union is taking Burger King and McDonald’s to court, arguing they’re cheating their staff of their rights to guaranteed hours and shifts. Workers’ hours and shifts would now be guaranteed permanently.
Unite National Secretary Gerard Hehir said it was a massive win for workers but McDonald’s and Burger King are ‘zero hour cheats’ and court action could be required. The union plans to file court documents within the next two weeks, he said.
McDonald’s had been putting many new staff on three-hour minimum contracts and refusing to pay compensation for being available to work additional shifts as required by the law. They are also refusing to offer hours to existing staff before hiring new staff, Hehir said.
Burger King had agreed to guaranteed shifts but had abandoned implementation of the collective agreement clause requiring this. Unite would be taking both companies to court to challenge their ‘cheating’ and attempt to ‘wriggle’ out of legal and contractual requirements they were forced to sign under public pressure last year, he said. ‘The people they are using and abusing are young, vulnerable, and often migrant workers who they hope won’t stand up for their rights.’
Unite Union and Restaurant Brands had clearly shown that secure jobs could be achieved in the industry, he said. ‘McDonald’s and Burger King now simply have no excuse for their failure to do what their employees, the law and the public of New Zealand so clearly told them last year.’