Difficulties managing high patient loads and low staff numbers came to a head at Rotorua Hospital over the weekend with the junior doctors' union claiming the emergency department should have been closed .
The New Zealand Resident Doctors Association (RDA) said the number of resident (junior) doctors hit "critically low levels" on the weekend.
Lakes District Health Board said the hospital had been under pressure in recent months due to a number of factors. More patients were appearing at the emergency department, there were not enough beds and the hospital was struggling to fill its staff roster due to people on sick leave and vacancies.
RDA said the hospital had been given advance notice it would be short a junior doctor on Friday and Saturday, but failed to arrange cover -- leaving the duty manager to cope.
The DHB said, "contrary to RDA claims, strong efforts were made to address and arrange medical cover".
However, it could only find cover for part of the shifts, leaving a five-hour period with no junior doctor in the wards.
RDA general secretary Deborah Powell said the emergency department should have been closed for that period and patients diverted to Tauranga or Waikato.
"Both DHBs and RDA previously agreed that minimum staffing levels outside ordinary hours must be maintained to avoid unacceptable risk. The minimums being breached are a risk to both patients and resident doctors."
Dr Powell said it was pure luck that nothing adverse happened.
Medical registrar Dr Jared Green said the problems were compounded through having a locum working his first shift in the emergency department and a vehicle crash boosting patient numbers.
Lakes DHB said the staff shortage had been discussed with clinical and service bosses and contingency plans were in place. An extra duty manager was brought in for the five-hour period and the on-call physician was available if needed.
After receiving feedback on the Friday shift that doctor was called to cover Saturday.
The DHB said it was "very grateful" to those junior doctors who supported their colleagues and the DHB during a difficult time and looked forward to their further support.
The RDA warned doctors may not be so co-operative.
"Understandably, Dr Green along with other medical professionals are not willing to place themselves again at such a high clinical risk."
The RDA also complained doctors were advised of the shortage via email rather than by phone. Lakes DHB said it would call next time.
In the meantime, Lakes DHB said hospital managers were working to resolve problems at the hospital with the most immediate focus on recruitment.
