The senior doctors union is calling out Te Whatu Ora for the quality of its workforce data with large discrepancies between data released to the union and Stuff.

Data collated on March 31 showed 3 FTE registrar vacancies in Auckland, for example, but in numbers released to the Association of Salaried Medical Specialists (ASMS) under the Official Information Act – which were collated on April 3, – Te Whatu Ora recorded 38.21 FTE open registrar posts.

ASMS Executive Director Sarah Dalton fears health bosses cannot quantify workforce shortages and in the meantime, doctors who have been trying to raise the alarm “feel like they’re shouting into a void”.

Te Whatu Ora had acknowledged that data was still being collected differently across districts and that it was working to improve this.

The data released to ASMS also showed Te Whatu Ora paid $42.35 million to hospital doctors and surgeons for extra duties to cover roster gaps in the 2022-2023 financial year.

Lat month, Stuff reported that Te Whatu Ora had more than 7000 full-time worker vacancies across the country’s hospitals – with almost 40% of those vacancies being for nursing positions.

Dalton said this was an underrepresentation of shortages.

Te Whatu Ora’s own 2023/2024 Health Workforce Plan reported a gap of 8320 staff across the health system and that number grows by another 12,381 by 2032 to maintain current patient to staff ratio.

There was an immediate shortage of 1700 doctors across primary and secondary care, the report said.

“We think that’s an undercut,” Dalton said. “Staffing levels have not kept pace with acute demand, let alone elective.”

ASMS Southland branch president Roger Wandless – who works as an anaesthetist at Southland Hospital – said that while the government had increased health spending, demand was growing faster.

“For a long time resources haven’t met demand, and it’s reached a tipping point,” he said.

This demand has been driven by a growing and ageing population who are showing up to hospital sicker – because they can’t get to a GP – or with more co-morbidities (risk factors).

Conditions becoming ‘intolerable’

The increased pressure combined with staff shortages meant healthcare workers were skipping breaks, staying later, struggling to maintain work/life balance, losing morale and heading for burnout, Wandless said.

And this led to staff having to take time off or resigning: “For those that are left it becomes intolerable, and they leave.”

Doctors were spending their time phoning patients to cancel procedures, managing little more than urgent and cancer surgeries, he said – a moral injury for doctors who simply want to provide the best care they can.

“It’s kind of like a whack-a-mole of roadblocks” – some days the problem is a lack of bed, some days it’s not enough staff; but as soon as one challenge is resolved another popped up.

Wandless felt that health authorities were starting to listen to doctors’ concerns but with a global health workforce shortage of about 7.2 million workers according to the World Health Organisation, they had to do more to attract new staff.

Doctors needed to know they wouldn’t have to work beyond their contracted hours or be “fearful that you could lose half your department in a couple of months and be the last one standing”.

Dalton also acknowledged the global workforce shortfall and that doctors traditionally came to New Zealand for the lifestyle rather than money.

But until that lifestyle had been reestablished, the only incentive to attract and retain staff was money, she said.

The union is gearing up for an historic strike next week, marking the first time senior doctors have walked off the job nationwide, after wage negotiations failed.

Doctors are asking for an inflation-related increase of between 7 and 8% – which Dalton believes is the least Te Whatu Ora could do to retain staff in an environment where vacancies are sometimes open for months on end.

Doctors felt like their warnings over the clinical risks short staffing could cause had gone unheard, she said.

“It’s incredibly frustrating. That’s a huge part of why our members have voted to take strike action.”

Shortages ‘a long-standing issue’

Te Whatu Ora workforce planning and development director John Snook said the agency knew that pressure from workforce shortages was being felt on the front lines; impacting on staff and the services they could deliver.

“We can’t fix those shortages quickly as they are long-standing issues which we are committed to fixing in partnership with educational institutions, unions and professional regulators,” he said.

Pointing to the Health Workforce Plan released in July, Snook said it was the first time New Zealand’s health system had articulated current and future shortfalls.

“Being able to do so allows us to give steers to the education sector, to the immigration system, and to our workforce about what we need – which is the first step in addressing the gaps we have.”

Since March 2017, the number of nurses employed by Te Whatu Ora had increased by 4108 FTE nationally and the number of doctors had increased by 1655 FTE, Snook said.

The agency was focusing on immigration pathways to recruit specialists from overseas and creating more training places to grow the local workforce, he said.

Addressing workforce data discrepancies, Snook said: “We know that the data from our Health Workforce Information Programme may not be a true representation of RMO vacancies.

“This is due to a range of factors including where the data is drawn from, and the varying reporting methods across the districts.

“Following the inception of Te Whatu Ora, we are working on combining processes and systems from 29 organisations.”