Failures to Reach Emergency Targets Signify Doctor Shortages

7 November 2011

“Failure to Achieve Emergency Department Target a Symptom of Specialist Doctor Shortages; Other Targets on Shaky Ground”

Senior doctor shortages in public hospitals are helping prevent the government achieving its target for emergency departments, according to the Association of Salaried Medical Specialists (ASMS).

ASMS, the union representing senior doctors and dentists, is concerned at the lack of progress on a blueprint agreed with DHBs last year to address an ongoing shortage of medical specialists. It has produced the sixth of a series of Specialist Workforce Alerts which outlines how critical hospital specialist shortages threaten the achievement of government health targets.

Last year the government set district health boards a number of “Health Targets”. These include reducing the time it takes for patients to get through emergency departments to less than six hours (in 95% of cases). At the end of June this year 11 out of 20 DHB’s had failed to meet the target.

ASMS Executive Director Ian Powell says the fact many DHBs can’t achieve this target comes as no surprise.

“At the front of the “front-line” are emergency medicine specialists. We know that the earlier a patient is seen by a senior person, the shorter their stay in the emergency department yet we are seriously short of specialists in this area.”

He says the Australasian College for Emergency Medicine has estimated in the past that New Zealand needed a minimum of 180 specialists to achieve an acceptable standard of care. However New Zealand Medical Council registration data show there were only 142 emergency medicine specialists practising in June 2011.

“We also don’t have enough other specialists in the main hospital to cope with patients who need to be transferred there from the emergency department. This target requires a ‘whole-of-hospital approach but specialist shortages in both emergency departments and the rest of the hospital are compromising it.”

Ian Powell says the shortage of senior hospital doctors is causing DHBs to miss other government targets and is leaving still others on shaky ground. It is pushing too far an already over-stretched senior doctor workforce.

He says it is welcome news that waiting times for cancer treatment have been reduced, but the target in this area is confined to radiation treatment.

“Sustaining that achievement as demand increases is an ongoing challenge, but the greater challenge is to improve cancer services overall - including improvements in cancer medication and palliative care services, and implementation of the new National Plan for Child Cancer Services.”

He says waiting times for these broader cancer treatments are affected by specialist shortages. Several medical specialties that work in cancer treatment are currently on New Zealand’s Long-Term Skills Shortage List include radiation oncologists, medical oncologists, pathologists, medical physicists, and palliative medicine specialists.

Ian Powell says while the Government’s target to increase elective surgeries by 4,000 a year has so far been achieved, the Ministry of Health has advised the Minister that some DHBs are often faced with capacity restraints “that are often due to shortages of specialist staff.” Further, some of this has been achieved by changed methods of recording.

“To keep this up we need 77 new surgeons a year, but at the moment we have just 45 coming through annually. Compounded by a shortage of anaesthetists, who are also on the Skills Shortage List – we are soon going to fail these targets”, says Ian Powell.

He says hospital services are already stretched to cope with current demand yet the demand is continuing to grow, and the government’s response has largely been to ask an overstretched workforce to stretch themselves further.

ASMS is calling for the DHBs to act on the blueprint agreed last year to address ongoing shortages of medical specialists.

“As well as continuing growth in demand there is stiff international competition for specialist staff, and we are facing a period of increased retirements – all of which are making services increasingly vulnerable.”

“If the DHBs continue to duck this issue, New Zealand’s health service and the health of New Zealanders will be at risk” concluded Mr Powell.

ENDS

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