One of the country's largest training centres for intensive care specialists has lost its accreditation amid reports of bullying and harassment.
Auckland City Hospital's department of critical care medicine was stripped of its training accreditation last year, with concerns including bullying, harassment and a lack of adequate in-house training.
The Auckland District Health Board (ADHB) has applied to get accreditation back and maintains it has addressed all of the concerns raised. It says the problem has not affected patient care.
However, the New Zealand Resident Doctors' Association is concerned it learned of the situation only through its members, and has now developed a "Plan B" in which doctors could be sent to Australia for training if accreditation is not restored by December.
Association secretary Dr Deborah Powell wrote to the ADHB in February: "This has the potential to impact on not just ICU [intensive care unit] trainees, but those in emergency medicine, anaesthesia, surgery and medicine and has knock-on effects to specialties such as neurosurgery."
The issues in Auckland come after Dunedin Hospital lost its status as an intensive care training facility in November, with the main issue being the state of the unit's facilities.
This week, it was revealed the hospital had lost orthopaedic training accreditation as well, although it is confident that will soon be restored.
Labour Party health spokeswoman Annette King, whose office obtained Dr Powell's letter under the Official Information Act, said that with the developments in Dunedin, "this doesn't look good".
"The culture of bullying ... has been permeating through the health system, and it is becoming more and more obvious," Ms King said.
Dr Powell told the Weekend Herald her members had made allegations of bullying at the Auckland centre, but were not willing to raise them formally out of fear for their careers.
Trainees at the centre are qualified doctors with four to eight years' experience, mostly studying to become intensivists, who specialise in the care of critically ill patients, usually in an intensive care unit.
"Bullying is a sustained, targeted behaviour," Dr Powell said. "And unfortunately it was significant in the unit. [It is] what I would consider on the severe end of the scale."
She declined to give details.
Bullying and harassment were among issues identified by the College of Intensive Care Medicine of Australia and NZ, which withdrew accreditation on November 20 last year.
Others included proper presentation of data, a pattern of rostering that did not allow for continuity of care, and trainee involvement in the main daily ward round was limited.
An ADHB spokesman said all the issues had been addressed, and it had been made explicit that bullying and harassment were not tolerated.
The issue of culture had been discussed with the college and Dr Powell's association, and the ADHB was placing a great focus on workplace safety.
"The culture flows from the leadership and this is the reason we welcome the new service clinical director and the skills she brings."
The suspension of training accreditation did not affect patient safety standards or the quality of care provided, nor the qualification sought by the current group of nine registrars who were in training.
The ADHB had asked the college to visit the centre again to review the improvements.
Dr Powell said she understood improvements had been made, but if accreditation was not regained this year, it would have a significant effect on rostering within ICUs.
"Nine may not sound a lot. But we are talking small numbers of fully qualified consultants in ICU across New Zealand, maybe about 150."
A spokeswoman for Health Minister Jonathan Coleman referred questions to the ADHB, but said he took allegations of bullying seriously and would expect them to be properly investigated.
Ms King said Dr Coleman needed to say what action he was going to take about these issues and other reports of bullying and culture problems in the health sector.
