The Association of Salaried Medical Specialists (ASMS) says the reason the Auckland Sexual Health Service is struggling to fight a syphilis outbreak in the city is a direct result of job cuts made in 2017.
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This week Auckland Sexual Health Service physician Dr Sunita Azariah said a lack of resources was hampering its ability to contact trace and control the spread of the disease. She said the service only had two nurses to carry out contact tracing, along with their other duties.
The service is funded by the Counties-Manukau, Auckland and Waitemata District Health Boards and run by the Auckland DHB (ADHB). The ADHB said staffing levels for all of its services are regularly reviewed.
ASMS executive director Sarah Dalton said the ADHB carried out a review of the Auckland Sexual Health Service in 2017 and decided to cut the number of senior specialists it had.
"At the time they had five fulltime doctors for the whole of Auckland, which we argued wasn't enough," she said.
But Dalton said the ADHB went ahead with the job cuts anyway.
A letter from March 2018 from the then ASMS executive director Ian Powell to ADHB chief executive Ailsa Clare shows concerns were raised about the impact redundancies would have on the control of the disease.
Powell said the DHB had made the job cuts, despite there being a notified syphilis outbreak.
"Syphilis cases continue to rise - and, we are advised, are now appearing in heterosexual men and women (and babies) as well as men who have sex with men."
No need for 'Third World diseases'
Dalton said the Auckland Sexual Health Service needs more support to control the dangerous communicable disease.
"There's no reason we should have congenital syphilis in New Zealand. It's like rheumatic fever. These are Third World diseases and they shouldn't be appearing in Auckland, or anywhere in New Zealand for that matter."
Syphilis is a sexually transmitted infection which can be treated and cured with antibiotics. But if it isn't treated, over time it can affect the brain, spinal cord and other organs.
Data from the ESR (Institute of Environmental Science and Research) shows in the 12 months to the end of June 2019 there were 248 cases recorded in the Auckland region and 624 cases nationwide.
According to the Ministry of Health, in New Zealand syphilis has been increasing since 2012, particularly in men who have sex with men. But syphilis rates in heterosexual men and women have also been increasing.
Disease making a comeback
The disease was all but wiped out after World War II through treatment using penicillin, but it has now made a comeback. And according to the Ministry of Health, similar increases in the disease have been seen in Australia, the UK and the US in recent years.
The growth in syphilis cases in the heterosexual population has also led to an increase of congenital syphilis, where a woman infected with the disease passes it onto her unborn child.
ADHB director of adult community and long term conditions Sam Titchener said the 2017 staffing changes hadn't adversely affected the Auckland Sexual Health Service's ability to manage its syphilis contact tracing programme.
"As is usual practice within District Health Boards, we regularly review all our services to ensure we are making the best use of resources to provide optimum care for our patients," she said.
"After extensive analysis and consultation we implemented staffing model changes to Auckland Sexual Health Service in a phased approach over the course of the 2017 calendar year."
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