''I have not taken this decision lightly but am so frustrated and disenchanted that I am no longer prepared to continue as clinical leader in the current environment,'' Prof Gwynne-Jones told colleagues yesterday in an email obtained by the Otago Daily Times.
However, he will continue his work as a surgeon.
''After five years, I am tired of fighting and having my work and recommendations questioned or ignored by management.
''Within the DHB there is no leadership or vision, no recognition of the current problems and no planning for the future,'' Prof Gwynne-Jones' email said. There was a lack of funding for Dunedin orthopaedic surgery.
''We are now performing significantly less joint replacements than the NZ average despite our increased demand.''
In the past nine months, 40% of patients listed for joint replacement had been denied the operation. Wards were frequently understaffed; the heavy workload was a ''huge problem''.
''We have strongly advocated for a consultant-run trauma list [for acute patients] ... but are unable to make any progress.''
Management refused to believe there was a problem, he said. Orthopaedic figures were ''bundled up'' with Southland, making them look better.
Relationships had come under strain because of the lack of resources.
''The clinical leader is the point of contact for all day-to-day clinical and service issues.
''They are also expected to lead, innovate and plan for the future of their service, within a zero-budget environment, and keep up a full clinical workload.
''My clinical work is beginning to suffer and, sooner or later, this may result in a mistake or omission.''
His persistent advocacy had had some success, the email said.
This included the commissioning of the ninth operating theatre at Dunedin Hospital, ''even if the final result did not quite match expectations''. When contacted by the ODT yesterday, Prof Gwynne-Jones declined to comment.
Last night, patient services medical director Dick Bunton said the board's managers should not be seen as the ''ogre''. Funding pressure was driven by the Government.
The Ministry of Health insisted the board had enough money, but did not spend it efficiently, he said.
''There is a basic conflict. It is almost unreconcilable currently with what perceived clinical need is, and what the DHB is funded to do.
''If we had adequate funding, we would be the first people to throw more money into particular areas to make it what might be perceived as a very happy, productive workplace, but the reality is we ain't got it.''
While all departments felt underfunded, some were better at seeing the ''bigger picture'' and understanding the limits, Mr Bunton said.
''There's not a department in the hospital that believes they are adequately resourced.''
