Bullying Rife In NZ Hospitals

The NZDoctor.co.nz website reported today on last night’s Wellington forum on the subject of burnout in the medical profession.

Experts said that doctors in New Zealand aren’t good at giving each other the support and affirmation needed to avoid burnout. Furthermore, hospitals are rife with bullying

Hospitals rife with bullying

“A bullying culture exists at hospitals, said forum chair John Carter, clinical leader of haematology at the Wellington Blood and Cancer Centre…

Attendees at the forum, part of the Inaugural International Cancer Symposium organised by Otago University, Wellington, heard psychiatrist and academic John Adams emphasise the medical profession’s poor record of giving mutual support and feedback.

This is an important factor in burnout, says Dr Adams, chair of the Medical Council.

By the time doctors come to the council’s attention, when their behaviour is affecting other staff and patient care, stress and burnout have led to physical health problems.

Depressive symptoms, anxiety, sleep disorders and/or substance abuse will have developed, and a stigma is attached to seeking help, Dr Adams says.

The earlier the problem is identified, the more likely its impact on the individual will be ameliorated…” read the full report here

Which is ironic considering that New Zealand’s laid back lifestyle is used as a major selling point to attract overseas doctors into the country.

New Zealand has been suffering a severe shortage of medical specialists for some time.

Coincidentally The NZ Herald published an article today headed Doctor shortage reaches ‘crisis’ level, saying that a spiraling shortage of doctors “has sparked a warning of future “severe safety issues” in New Zealand hospitals.”

Association of Salaried Medical Specialists director Ian Powell told the paper that the flow of New Zealand doctors overseas and difficulty of replacing them had put many hospitals in crisis.

Patients could suffer from increasing medical mistakes and treatment delays without urgent action, he said.

“The situation is already unsustainable. We’ll have severe safety issues if this continues.

“New Zealand is losing too many of the younger doctors we train so well overseas, losing too many of our current public hospital senior doctors overseas and struggling to recruit in a very tight and internationally competitive market.

“Eventually these chinks are going to get so big that the system breaks down.” … read the full report here

Some things you may like to know about the health service in New Zealand:

Understaffing

There is a workforce crisis in New Zealand’s hospitals. Specialist senior doctors are being lost and there is a shortage of cancer specialists. Staff are lost to Australia (where the salaries are 35% higher) and to private practice. The causes are low pay by international standards, overwork and lack of resources to do the job.

New Zealand has an estimated shortage of around 600 specialists and that’s set to get worse, according to the Association of Salaried Medical Specialists. Growth has not kept pace with increasing need in an aging population.

The senior doctor’s union estimates there is a shortage of 638 medical and surgical specialists and that having to treat too many patients is driving doctors away from NZ. The country “needs at least 1100 more specialists if it were to match the number per head of population in Australia, the union says in a discussion paper based on data from 2007 and 2008.” Source NZ Herald.

New Zealand’s has a high dependence on overseas-trained doctors, the highest in the OECD , who comprise 40% of specialists. In some areas, such as psychiatry, the figure is closer to 60%.

So many NZ trained registrars go overseas when they’re qualified that it’s hardly worth training them at all. Medical registrars can earn around $70,000 more in Australia and difference in salaries is one of the major drivers for the exodus. “The situation is a crisis and a crisis generally comes before a collapse” -says Association of Salaried Medical Specialists executive director Ian Powell. See the bullet point above for the other drivers.

But its not just the medical profession that are suffering in New Zealand, patients are doing it hard too:

Adverse Effects on Patient Health

A shortage of Oncologists in the central part of the North Island means that some cancer patients are being refused chemotherapy. Instead of being placed back on waiting lists patients are being referred back to their own doctors (as of Jan 2011) Affected patients include those suffering relapses of some cancers, including cervical, oesophagus and melanoma.

The Chief Exec of the NZ Cancer Society said

“It might not be what we want to hear, but it is honest … It is good to know they will not be hiding patients on waiting lists.”

But the list of cancers that won’t be treated had only been intended for clinicians to see, not the general public.

Cancer treatment services are under such pressure that current treatment levels are unsustainable unless more money is spent. Rationing is likely to “become a feature.”

An economist said that New Zealand’s cancer-treatment rates were lower than the average for developed countries.”Already we have unmet need, so I guess the message is, get used to it.”

261 people in Canterbury are waiting more than six months for cancer-detecting colonoscopies, raising alarm among doctors. In July 2009 the figure stood at 75 people. A private procedure costs £1,000.

A “postcode lottery” health system is failing people as there is “inequitable” access to treatment depending on where patients live. One woman failed to have a brain tumour diagnosed for over three years. A report into her case has highlighted serious deficiencies within NZ’s public health service.

Hospital errors causing serious harm are rising. In the year to June 2010 there were

“374 patients who were involved in a serious or sentinel event, of whom 127 died; compared with 308 events, including 92 deaths, the year before.”

Migrants Tales

Are you still considering a move to NZ to work in the medical profession? Read some of our Migrants Tales, for example this one

“The Health Care System Is Second Rate”

This story was written by a nurse with over 30 years of experience. In it she tells of prejudice and how difficult it was to find a job. She also talks about how thousands and thousands of health care dollars are being wasted because there is no incentive to change and of how people wait so long for some tests and treatments that permanent damage is done to their health. She is minded to stay and work through this but her Kiwi partner is starting to look toward Australia to make some money….read on

You may also find interesting: “Kiwis Missing Out On Vital Medicines with Fatal Consequences“

Have known a couple migrant nurses here, and this is no surprise! I also know migrants who worked in laboratory quality control oversight, since moved on, and what they said was scarey as well. The number of individuals who slip through the gaps in the health care system, or are dropped through, is very high. Operations that an HMO would cover in the U.S., for instance, at a minimum charge are elective here. The NHS will get around to them eventually, but New Zealand excludes them entirely unless you have reached a point of acute pain or emergency. So you have to “go private” and pay out the nose to head off an emergency. What utterly galls me is their smugness at having a system they think is better than anyone else’s. It’s like the Warehouse. A heavy dose of Kiwi ego on the surface, but everything in it is imported, cheap and you take your chances it’ll hold together in the wash. A friend of mine suggested, “Kiwis don’t want to pay more out of their own pockets for some other person to have a better chance at life”. What is lacking here is a general sense of altruism, which possibly results from the scanty resources. Everyone takes advantage, shamelessly, 24/24, because of the lack of plenty, and the voracious nature of their culture. This is reflected in their institutions, but as with everything here you have to live it for awhile in order to find it out. The same friend said that this was why they did not have all-you-can-eat buffet-style restaurants here. That concept depends not only on a continuous supply of resources such as you would find on a larger continent, but also general acceptance of the concept that you will not abuse that plenty. Tourists who are charmed by those rural farm “honor system boxes” come to the conclusion that these are somehow representative of the entire society. Like everything else in New Zealand, though, the behaviour is vastly different depending on the situation, stakes and circumstances. The honesty and transparency “on offer” are just that – something sparkly in a showcase. New Zealand is not a “better, older” golden retro version of any other country, people! Read E2NZ and learn!

One thought on “Bullying Rife In NZ Hospitals”

Scotty says:

February 17, 2011 at 7:36 am

Have known a couple migrant nurses here, and this is no surprise! I also know migrants who worked in laboratory quality control oversight, since moved on, and what they said was scarey as well. The number of individuals who slip through the gaps in the health care system, or are dropped through, is very high. Operations that an HMO would cover in the U.S., for instance, at a minimum charge are elective here. The NHS will get around to them eventually, but New Zealand excludes them entirely unless you have reached a point of acute pain or emergency. So you have to “go private” and pay out the nose to head off an emergency. What utterly galls me is their smugness at having a system they think is better than anyone else’s. It’s like the Warehouse. A heavy dose of Kiwi ego on the surface, but everything in it is imported, cheap and you take your chances it’ll hold together in the wash. A friend of mine suggested, “Kiwis don’t want to pay more out of their own pockets for some other person to have a better chance at life”. What is lacking here is a general sense of altruism, which possibly results from the scanty resources. Everyone takes advantage, shamelessly, 24/24, because of the lack of plenty, and the voracious nature of their culture. This is reflected in their institutions, but as with everything here you have to live it for awhile in order to find it out. The same friend said that this was why they did not have all-you-can-eat buffet-style restaurants here. That concept depends not only on a continuous supply of resources such as you would find on a larger continent, but also general acceptance of the concept that you will not abuse that plenty. Tourists who are charmed by those rural farm “honor system boxes” come to the conclusion that these are somehow representative of the entire society. Like everything else in New Zealand, though, the behaviour is vastly different depending on the situation, stakes and circumstances. The honesty and transparency “on offer” are just that – something sparkly in a showcase. New Zealand is not a “better, older” golden retro version of any other country, people! Read E2NZ and learn!