11 Jun 2019

Junior doctors strikes: District Health Boards pay more than $19m for cover

7:32 am on 11 June 2019

Strikes by junior doctors this year have cost district health boards more than $19 million and there's no end in sight.

Junior doctors striking outside Wellington Hospital today.

Junior doctors striking outside Wellington Hospital earlier this year. Photo: RNZ / Karen Brown

Members of the Resident Doctors Association (RDA) have held five strikes since mid-January in a row with their employers over proposed changes to their now-lapsed employment contract.

It's still unresolved, with a ruling from the Employment Relations Authority expected soon, following eight days of facilitation recently.

Details released to RNZ under the Official Information Act show that 16 of the 20 DHBs have paid senior doctors $19.3 million since mid-January to provide cover.

Under an agreement reached before the strikes between the DHBs and the Association of Salaried Medical Specialists, senior doctors can be paid between $250 and $500 extra per hour, on top of their normal salaries, for providing cover. This is either for on-call duties including phone conversations, for extra "more onerous" duties, or hours worked outside normal duties, and for call-backs.

The OIA data shows Counties Manukau DHB in South Auckland - with a projected year-end deficit (in February this year) of $53.5 million - had paid most to senior doctors, at $2.45 million.

Next was Wellington's Capital and Coast DHB, which paid the senior doctors a total of $2.3 million for the five strikes. It paid between $403,000 and $442,000 for each of the four two-day strikes, and $644,000 for the five-day strike from 29 April to 3 May.

Auckland DHB paid $1.91 million, of which $1.9 million was payroll costs for senior doctors, while $849 was for meals for them over the five strikes.

Canterbury DHB paid its senior doctors $1.77 million for all but the latest strike, which the RDA did not carry out at CDHB in recognition of the impact of the mosque terror attacks.

The five strikes cost Hawke's Bay DHB $1.70 million, Waitemata DHB $1.66 million; Mid Central DHB in Palmerston North $1.44 million; and the Southern DHB $1.30 million.

The RDA could not be contacted for comment. DHBs were not available to be interviewed but said the $19 million had to be seen in the context of a wages bill for the health sector of almost $7 billion a year.

They said they were grateful for what the senior doctors had done, adding the payments to them were contracted and agreed in advance.

Former DHB chair Gregor Coster, who is the dean of the Faculty of Health at Victoria University, described the payments to senior doctors as a "substantial sum".

"The effect on DHB budgets is considerable, particularly when you bear in mind that they have combined deficits estimated to be over $300 million come the end of the Crown financial year [on] the 30th of June," Prof Coster said.

He said the costs of the strike to DHBs and others was higher when cancelled and postponed surgery and outpatient clinics were added.

"We have to be concerned about the public interest here. People's surgery is being delayed, outpatient clinics are being postponed, theatres are being cancelled. This is a concern and it certainly would be most desirable if we could see this resolved so that patients can get the health services they need."

Ian Powell, the executive director of the senior doctors union, the Association of Salaried Medical Specialists, said the $19 million figure highlighted the amount of pressure that the strikes have had on the health system.

He said doctors were "really over-stretched" and appreciative of a "hiatus" in industrial action currently while both sides await the findings, and recommendations, of the authority.

Mr Powell said he also believed the spending would have an effect on deeply indebted DHBs.

"Clearly it's going to ... make the position worse because chunks of their funding do depend on certain throughputs. So I think that it is going to have an impact."

Health Minister David Clark declined to comment, given that the DHBs and the RDA are awaiting recommendations from the ERA.

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