The senior doctors' union is unimpressed with what it calls a
"petty point-scoring" open letter Southern District Health
Board management has sent Dunedin Hospital emergency
In the letter, the board said "long-standing serious
relationship problems" with some senior doctors must be
resolved if the emergency department's new observation unit
is to work properly for patients.
"We need to be able to engage with ED medical staff in a
mature way. To that end we are looking for leadership from
senior doctors as we work through rostering and staffing
issues which concern us all."
The letter said two senior health figures - Ministry of
Health chief medical officer Dr Don Mackie, and national
emergency department target champion Prof Mike Ardagh - were
helping improve relationships between managers and doctors.
The board released the letter to the Otago Daily Times
after sending it to staff yesterday morning. It follows a
letter last month from senior doctors in which the doctors
told the board they could not provide adequate cover for the
observation unit as there were too few of them.
The two sides cannot agree on how many specialists the
department needs, a situation that led to clinical leader Dr
Tim Kerruish stepping down in March.
While he continues as a specialist in the department, it
still has no clinical leader and the board has made no
discernable progress towards appointing one.
The letter acknowledges improvements in the past year, which
cut waiting times.
"However, there are real issues with the ED and we need to
collectively work through these if we are going to make the
department work for the community we serve."
The letter urges the ED to be flexible about adopting new
models of care, including recognising the role of nurses and
relationships with other departments, both of which could be
enhanced for the sake of patients.
The letter also warned against airing problems "through the
Although not mentioned, one of the troubled relationships to
which the letter alludes is likely to involve specialist Dr
John Chambers, who faces possible disciplinary action over a
media interview earlier this year. He is yet to learn whether
he will receive a formal first warning.
Contacted for comment, Association of Salaried Medical
Specialists executive director Ian Powell said that rather
than soothing the situation, the letter risked "aggravating"
The board was engaging in "petty point-scoring", and should
not have sent an open letter without first advising the
"[The managers] need to learn to work collaboratively. It
does not seem to be in their DNA to work collaboratively."
He claimed the DHB was trying to drive a wedge between senior
doctors and other ED staff.
He found "offensive" an implication in the letter senior
doctors were not as dedicated as nurses and other staff to
maintaining a safe and efficient emergency department.
Concern over that inference prompted managers to clarify part
of the letter yesterday, a spokesman said. It had never been
the intention to suggest senior doctors were not "extremely
hard-working", he said.
The open letter was signed by patient services executive
director Lexie O'Shea, nursing and midwifery executive
director Leanne Samuel and patient services medical director