Comment permalink

The nationwide 48-hour junior doctors' strike appeared to take place with no ''hitches''. In other words, there were no major incidents in which patient care was compromised.

Of course, thousands of elective surgeries and outpatient appointments nationwide were postponed, creating a further backlog in a system where long waiting lists are already the norm in many areas.

Yet there has been little public outcry about the strike. It appears people are largely sympathetic to the plight of the country's several thousand resident doctors (also known as resident medical officers, house officers or registrars) and are equally concerned about patient safety.

Some of the horror stories which have emerged in the past few weeks have undoubtedly fuelled the fire. They include stories of junior doctors claiming they are so tired they are focused solely on trying not to make a mistake at work rather than delivering quality care.

Some say they have made mistakes around prescriptions and charting and have phoned in later to remedy them. Some say they have little energy to be empathic when dealing with patients.

Some report they have fallen asleep at the wheel on their way home from shifts. Some claim they are too scared to address their concerns with their superiors for fear of jeopardising their career prospects.

The central issue is rosters, which the Resident Doctors' Association says are dangerous - for staff and patients. Junior doctors work rosters which include seven consecutive nights and 12 consecutive days.

The union wants to reduce the seven consecutive nights to four (followed by three days off) and to reduce the 12 consecutive days shifts (followed by two days off) to a maximum of 10 days in a row (with four days off).

The DHBs say they will agree to some of the demands, including cutting the shifts by two days, but the bone of contention between the two sides seems to be whether the doctors should still be paid the same amount.

The competing claims are complicated and it is extremely difficult for an outsider to make a judgement. Are the doctors really endangering themselves and others? (Some argue the overall hours are necessary to gain the experience needed and provide continuity of care.)

Are the DHBs guilty of health and safety abuses? Should junior doctors ''harden up'' like their forebears had to, or have there been substantial changes that make the workload, conditions and expectations considerably more taxing nowadays?

Are the doctors being greedy? Are the DHBs being stingy? Who is being fair and reasonable in this debate? Oppositional stances often occur during any collective bargaining.

A cynic would argue supposedly vital components are readily dropped for the sake of a pay rise during negotiations.

If the junior doctors' claim really is only about safety, why is a pay cut out of the question? It seems natural the DHBs would expect a reduction in hours would mean a reduction in pay - and the money would be used to pay the extra doctors covering those shifts. Do penalty hours and the like complicate the equation? Is there inflation to take into account?

At the moment the doctors have the sympathy of the public, but the union needs to better explain its rationale for reduced hours/same pay if that is to remain the case.

If safety is an issue, that must be addressed - and urgently. Minister of Health Jonathan Coleman says it is unacceptable if junior doctors are working in unsafe conditions, but also says he has seen no objective evidence that is the case and he wants the two groups to settle their dispute.

Given these negotiations have been going on for 10 months, a quick fix seems unlikely. But if objective information is required to establish the facts when it comes to staff and patient health and safety, the minister should take the lead.

An independent inquiry might not be amiss.