Spam Journalism #62

By Jim McVeagh 31/10/2009

Spam Journalism: The spurious use of sensational headlines to add spice to an otherwise pointless article.

Well, half the headline is ok…

DHBs, union clash over plan to axe 20 doctors

Plans to cut 20 resident doctor positions at Auckland hospitals will increase the pressure on remaining staff and threatens standards of patient care, a unionist says.

But the health boards say the jobs will be replaced by 20 new positions in departments such as emergency medicine, geriatric care and paediatric intensive care, to provide more training positions where doctors-in-training had indicated they wanted them.

DHBs and Union clash. That’s like saying the sun rises in the east. Not exactly news. So the second half of the headline tries to spice up the article –  AXE 20 DOCTORS. Gets your attention. Pity it is not true.

The DHB is, in fact, transferring positions across to other disciplines because that’s what the junior doctors want. The same junior doctors that the redoubtable Ms. Powell is supposedly representing… No-one wants to be a registrar in gynaecology or in psychiatry, so the DHB is unable to fill the positions. It is then obliged to fill the positions with expensive, transient locums, not because they are necessary (though they may be), but because there are empty positions to fill.

Sensibly, the DHB has had enough and has moved these junior position to places where they will be more useful and, importantly, more popular. This means that they will have to do some restructuring of the services that are losing these positions, but that is better than using incessant locums. The use of locum doctors in psychiatry is especially to be deplored. The nature of psychiatric treatment is such that continuity of professional input is extremely important.

I note that the history of this is that extra registrar positions were set up in psychiatry following the debacle in Southland where a medical officer (senior non-specialist), Dr. Peter Fisher, discharged Mark Burton the day before he killed his mother, Paddy. Medical Officer positions were disestablished because they were “unsupervised” and registrar positions were put in their place. It has proven difficult to fill these registrar positions, so that, when medical officers left the field, the positions remained empty, putting pressure on other workers. However, any psychiatrist would tell you that s/he would rather see 50 patients a week, when s/he should be seeing 35, rather than 35 one week and 70 the next, as locum positions become unfilled.

It is not ideal that doctors should be working 62 hour weeks (though I am betting that this will turn out to be a bit of an exaggeration and worst-case scenario, knowing Deborah Powell). The DHBs will know that such an increase in hours is not sustainable. The simple answer is not, as Ms. Powell suggests, to pay the junior doctors more (they don’t want to take the positions, remember); the simple answer is to recruit more full-time specialists. This would enhance the service at a cost fairly comparable to the purchase of locums. Both Psychiatry (because of its very nature)  and O&G (because the easier stuff is dealt with by midwives and GPs), require a great deal of specialist input and junior doctors are often virtual non-participants, handling routine tasks only. This is why the positions are unpopular.

As long as the DHBs are actively addressing more viable long-term solutions, this appears to be a win for everyone.

With the possible exception of Deborah Powell.


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