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Blame DHBs, not the unions, for the junior doctors’ strike

16 January 2019 ASMS - Opinion: Ian Powell

OPINION: Blaming rivalry between health unions for the resident (junior) doctors’ strikes rather misses the point about who is responsible for the turbulent period of industrial strife that public hospitals now find themselves in.

Saturday’s editorial in Stuff  newspapers over-emphasises the importance of the new much smaller union, Specialty Trainees of New Zealand (StoNZ). The editorial fails to adequately recognise the complexity of the problem.

Resident doctors are in training, usually either to become general practitioners or hospital specialists.  There is a dilemma in the way New Zealand trains its doctors. It is through an apprenticeship model based on service provision. This model is a strength of our system, producing quality senior doctors.

But we also have fatigue, leading to a push for making the working hours safer for these doctors in training.  The dilemma is that enhancing safer hours requires more resident doctors, which fragments continuity of training, along with effects on handover and patient care.

This dilemma, and its unintended consequences, has been around for many years.  In 2016-17 the Resident Doctors’ Association (RDA) sought to further improve the safety of working hours in its national collective agreement with district health boards (DHBs) by introducing two additional requirements: a maximum of 10 consecutive working days, and four consecutive night shifts.  After acrimonious negotiations, which included two national strikes, the RDA succeeded with an agreement known as Schedule 10 to be added to the national agreement. As a result, this dilemma deepened further.

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