Senior doctor exodus reaches crisis point

Senior doctors are leaving New Zealand to work in Australia at the rate of one a week, according to a survey released exclusively to the Sunday Star-Times.

The union survey, by the Association of Salaried Medical Specialists, says 80 specialists have already gone or have resigned to work across the Tasman in the past 18 months.

That is leading to growing difficulties in caring for patients in certain areas, especially provincial areas which struggle to recruit specialists.

Even urban areas suffer ramifications, with Wellington Hospital last week announcing child cancer patients may have to travel to Auckland or Christchurch after one of its specialists resigned to work in Australia.

Paediatric oncologist Dr Wayne Nicholls left Auckland's Starship Hospital in April to work as a children's brain tumour specialist at Brisbane's Royal Children's Hospital.

Nicholls, 44, said his Australian salary package was 50% more than here, but the move was not just about money.

"In my case it was more money, significantly more money, but it was also better support for professional development."

He also gets significantly more in superannuation and has better opportunities, such as working on a team developing an adolescent cancer unit in Brisbane.

District health boards (DHBs) are embroiled in a pay spat with the union, which is threatening to take industrial action.

The union's survey showed those most likely to go were anaesthetists (13), followed by medical physicians (10), obstetricians and gynaecologists (nine), radiologists (eight), and psychiatrists and paediatricians (seven each).

Auckland and Counties-Manukau were worst hit, with 11 specialists leaving from each. Provinces like Southland, Northland and Bay of Plenty saw an exodus disproportionate to their populations.

College of Obstetricians and Gynaecologists NZ president Dr Alec Ekeroma said the exodus hit rural areas hard. Provincial hospitals, especially in Whangarei, Whakatane and Greymouth, all had vacancies in his specialty. Doctors in smaller hospitals were often on call every second night and lacked the resources of busier urban hospitals.

"It is a concern because it affects standards of care... you can be up all night dealing with a woman who has severe pre-eclampsia and be expected to person gynaecology clinics the next day until 5pm. By midday you're buggered... and thinking `I'm sure there's a better life somewhere else."'

Union executive director Ian Powell said Kiwi specialists were highly sought after in Australia because training and registration systems were similar. Pay rates were higher and conditions better overseas.

An Australian hospital recently offered a union member twice as much as he earns here, plus housing and a car, every fourth week off on top of annual leave, and frequent flights back to New Zealand.

The union is holding stopwork meetings nationwide as it tries to negotiate a new national collective agreement. So far, all have voted to hold a postal vote on whether specialists should take the unprecedented step of industrial action.

DHB spokesman David Meates, chair of the boards' medical workforce strategy group, said doctors had always left New Zealand to work offshore.

"If you look at the past 10 to 15 years, there hasn't been a change in doctors leaving New Zealand."

What has happened is a rise in foreign doctors working here, with a March report showing 41% of doctors registered here gained their early qualifications abroad.

Meates, Wairarapa DHB's chief executive, recently employed obstetricians from South Africa and the US because he could not find locally trained doctors.

Meates said the DHBs had made an offer of final position arbitration with the union. More meetings are scheduled in mid-August.

But that will come too late for Wayne Nicholls, who said it was unlikely he would return here to work because he would need similar opportunities and pay as in Brisbane.

Source:www.stuff.co.nz