Senior doctors are upset the decision was made without any consultation with them. File photo. Photo: RNZ / Karen Brown
Senior hospital doctors at Rotorua's Emergency Department (ED) are being told they will have to work at Taupō's ED, to ensure there are enough staff for it to remain open.
It would mean a two-hour return trip for doctors who say they feel blindsided, let down and disrespected by Health New Zealand.
In a letter leaked to RNZ, Te Whatu Ora Lakes senior manager Alan Wilson laid out some stark options.
He said they faced critical financial restraints and two crucial risks at the emergency departments.
Te Whata Ora has been unable to recruit more senior doctors to Taupō hospital and the ED there has multiple roster gaps, leaving the staff and community at risk.
The Rotorua ED risks losing accreditation as a teaching department unless it has 24-hour cover using doctors with a specific credential from the College of Emergency Medicine.
The solution is to merge the two ED's rosters with current staffing while they try to recruit more people.
One of the doctors affected told RNZ they were outraged.
"As an emergency department doctor I am used to being abused in my job - we are sweared at, spat on and physically threatened- but I've never felt as disrespected as I felt receiving this letter."
They said the news, made without any consultation, was a slap in the face.
"Morale is already low amongst senior doctors and this directive to travel an hour each way for our shifts will inevitably lead to more SMO resignations, compounding the original problem," they said.
Association of Salaried Medical Specialists executive director Sarah Dalton said she was alarmed.
"It's not safe, it's not reasonable, and it's a failure I guess of a health leaders responsibility to assess current staffing, levels of risk, to be truthful about those, with the communities that those hospitals are tasked with serving.
"There needs to be advocacy and honest conversations about the real cost of providing healthcare," she said
Dalton said the letter to staff, titled 'Working Differently to support our Emergency Departments and Communities' did the opposite of what it was intended to.
"It's trying to work un-safely and stretch an inadequate level of staffing across two sites that are an hour apart.
"I worry that it's a sign of things to come, and it's a terrible way to run a health system, where it says budgets are more important than people," she said
The letter outlined two other options that health officials considered and rejected.
One was having no senior doctor on site at the Taupō ED overnight - relying instead on nurses and a virtual doctor service. This was considered too unsafe.
The other was asking for more funding to recruit more specialist doctors at Rotorua ED - the letter says there is no available money.
In a statement, Wilson said Te Whatu Ora was exploring how to best continue delivering 24/7 healthcare in Taupō.
''Health New Zealand | Te Whatu Ora remains committed to providing a 24-hour Emergency Department in Taupō.
"The Taupō Hospital service offers a high standard of care that includes specialist ED doctors and Rural Hospital Medical Specialists.
"Like a number of other services, we are experiencing some challenges around staffing, and we are currently exploring options as to how best to continue delivering 24/7 healthcare and advice to the Taupō community.
"We currently have four vacancies in Taupō Hospital ED, with no current applicants for these positions. One of the options we are considering is a proposal that would see staff from Rotorua undertaking some of their shifts in Taupō Hospital ED until such time as the staffing shortage in Taupō improves."
Wilson said Rotorua Hospital currently had 1.4 vacancies in its ED, with multiple applicants for the roles, which provided the ability to recruit additional staff to support the district through providing some shifts in Taupō Hospital.
"People can remain assured that we are committed to their safety - and that of our staff - and we continue to work with our partners to find the best solution for the communities we serve with the resources we have.
"Staff will be consulted in the coming weeks about the proposal, and we encourage staff to discuss any concerns they may have about the proposal with us directly."
However, Dalton said the proposals breached the collective agreement.
"Taking this approach to significantly changing a model of care and peoples employment contracts, you can't unilaterally do that according to our collective agreement, so this is completely in breach of that, it's a breach of good practice, and it's ignoring the basic safety issues that there are communities in Rotorua and Taupō who need access to safe healthcare."
She said the proposal would not be able to go ahead without consultation.
The letter clearly stated the roster change was happening, but Te Whatu Ora now said staff will be consulted in the coming weeks.
