Claim training environment unsafe

Jean-Claude Theis.
Jean-Claude Theis.
Orthopaedic surgery at Dunedin Hospital is not adequately staffed to provide a safe training environment, Dunedin Hospital orthopaedic surgeon Prof Jean-Claude Theis says.

Dunedin Hospital has been allocated no orthopaedic trainees for 2016 because of issues in the department.

Yesterday it emerged the accreditation issue was part of a long-running row between senior doctors and management over whether the department has enough staff.

The row was also the catalyst for the resignation of clinical leader Associate Prof David Gwynne-Jones last year.

Prof Theis had expressed the concerns to the New Zealand Orthopaedic Association, which is responsible for trainee accreditation.

''I was concerned about the training for our trainees here, the lack of supervision,'' Prof Theis said.

And he said the issues had not been sorted out, which was at odds with what patient services medical director Dick Bunton said this week.

One of the accreditation issues was a lack of a dedicated acute orthopaedic list, which is part of caseload requirements.

Mr Bunton said the list was provided, but the hospital lost the positions anyway.

Prof Theis said ''the issue of resources to supervise the list has not been solved''.

There were too few consultants to provide a safe level of supervision while trainees were operating.

''If we want to be available every day in the acute theatre we either can't do clinics or we'll have to reduce our elective operating list, or they'll have to give us more FTEs [full-time equivalents] to be able to cover this.

''If we carry on doing the work that we do at the moment, we will not be able to cover this every day.''

The board plans to hire two registrars instead of the trainees, but Prof Theis said registrars increasingly needed supervision because they had less prior experience than in the past.

''The issue has been a problem for some years and has been highlighted, but management decided not to do anything about that.''

Prof Theis said trainees should not be placed at the hospital until the issue was resolved.

Association of Salaried Medical Specialists executive director Ian Powell said senior management had a culture of ''sneering'' at doctors and not addressing their issues.

''If I could give the commissioner one piece of very simple advice - put a rocket up senior management because it's a culture of non-responsiveness.''

However, Mr Powell said the new surgical directorate medical director Stephen Packer deserved credit for pulling together the last-minute response to the association to try to keep the trainees, which had been a worthy attempt.

Yesterday, Mr Bunton denied the department was understaffed, and said every department probably felt the same way.

He said he was surprised by Prof Theis' comments, as he thought the supervision and caseload concerns were resolved by the last-minute response furnished to the association.

''If that's his view, I guess it's his view.''

He denied the senior management team had a culture of dismissing senior doctors' concerns.

New Zealand Orthopaedic Association council board member Mark Wright, of Auckland, said the orthopaedic surgeons and senior management needed to work together to resolve the concerns.

''I think the orthopaedic surgeons have not been happy about the resources provided to them.''

Mr Wright said he expected Dunedin to receive trainees again in due course once the issues were sorted.

eileen.goodwin@odt.co.nz

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