Shortfall of specialists
DHB disputes survey results showing Northland worst in country
Jasmine White has been waiting since January for an appointment with a rheumatologist — and now she’s been told to wait for at least another 10 months before an auto immune disease is fully diagnosed.
The Whanga¯rei mother is among Northlanders on the waiting list for specialist appointments as a survey highlighted the effect of the shortages on senior doctors at public hospitals, their workload, and their ability to treat patients.
A staffing survey by the Association of Salaried Medical Specialists (ASMS) found the shortfall of hospital specialists across all branches of medicine at the Northland District Health Board was the worst of nine DHBs in the country.
ASMS has been looking at senior doctor staffing levels at DHBs since 2016 by surveying clinical leaders in hospital departments.
The aim is to assess how many full-time specialist positions are needed to provide quality and timely treatment for patients.
The Northland survey found an estimated staffing shortage of 36 per cent.
ASMS said the heads of departments at Northland DHB estimated they needed 60 more full-time specialists to provide safe and appropriate care to patients and the community.
Despite that and at the time of the survey, ASMS said only 26 full-time positions were officially listed as vacant.
Northland DHB is disputing it needs 60 more medical specialists.
But White, 22, said there has to be a shortage of specialists in public hospitals, given the length of time she has been asked to wait.
In January, her GP diagnosed her with an auto immune disease but she wouldn’t know which one until she was seen by a specialist.
“Daily I suffer from dry, burning and itching skin, swollen joints with redness from inflammation, flu-like symptoms when I’m in a flare and some days, I even spew. These are only some of my symptoms.
“I don’t know how long I can wait anymore and the cost of seeing the doctor every single week without any help costs an arm and a leg but I have to work as a cleaner just to see the doctor.
“I have been prescribed lots of different medications and nothing has helped. I feel like a guinea pig. I have had several positive tests and multiple high liver enzymes test.
“I am very disappointed in the health system because I
suffer from chronic pain every single day and it feels like nothing is being done.”
White said it would cost her $400 for an initial appointment with a rheumatologist outside of the public hospital system, and $250 for each follow-up visit.
Of the 196 full-time specialists, 166, or nearly 84 per cent, are ASMS members.
ASMS executive director Ian Powell said such a low official vacancy rate of 26 full-time positions looked like the Northland DHB was trying to fudge the seriousness of the shortages.
“This survey shows a workforce which is under immense pressure in trying to hold the public health system together and it’s not sustainable.”
Powell said the previous eight DHB surveys revealed shortages ranging from 17 to 27 per cent.
Northland DHB chief executive Dr Nick Chamberlain said if the vacancy numbers at the time of the survey were 26, then that was a very transparent figure obtained by subtracting the funded and budgeted number of positions, less those currently employed.
“We can only assume that the figure of 60 vacancies comes from asking clinical directors what they believe they need or would like to have in an ideal world.”
He said Northland DHB has the largest number of senior medical officers per head of population for a secondary care provider, or roughly 110 per 100,000 population compared with the New Zealand average of 93.4.
Chamberlain said 18 full-time positions were vacant and 13.5 posts have been offered and are due to commence over the next six months. Seven offers are out for consideration.
He said rural hospital medicine, radiology, gastroenterology and psychiatry were the most challenging positions to fill.
Over the past few years, he said the senior medical officer workforce has grown by about 6 per cent or 10 to 15 full-time positions a year to keep up with rapid population growth and the increasing complexity of Northland’s very high-needs population.
“We have a lot to offer senior medical officers at Northland DHB, and we are fortunate to have such high-calibre medical staff working here with supportive teams and a strong culture of collaboration, compassion, learning and excellence.
“Although attracting the right talent from within New Zealand and overseas has become even more competitive, we take a strategic approach to recruitment, which includes being clear on what we can offer potential employees and ensuring new employees are a good fit with our values-based organisation,” Chamberlain said.