For the past several weeks the QLD media has been publishing stories on an industrial dispute between doctors employed by QLD health (that is, public doctors) and the State Government. The dispute centres around attempts by the State Government to modernise the health system. The issue for doctors is the Government's requirement that all doctors sign individual contracts. These contracts require doctors to be flexible in respect of their work locations and hours of service. That is, they may be required to work at other locations, be on call and work in excess of their base hours of duty as required by the operational needs of the Health Service. They are required to meet Key Performance Indicators (KPIs) set by QLD Health. They are required to comply with all policies and procedures set by QLD Health, such policies and procedures to be amended at the discretion of QLD Health.
Significantly, the Hospital and Health Boards Act 2011 was amended in 2013 to provide the Chief Executive with the power to issue Health Directives dealing with the conditions of employment of health service employees (s51A), and, in accordance with ss51C(3) such directives override the conditions agreed in any contract of employment.
The argument on the doctors side is that the contracts put too much power in the hands of non doctors (health bureaucrats in relation to the setting of KPIs and policies and procedures) which may impinge on clinical issues (that is, patient care). They are also concerned that the contracts may be changed at their employer's whim. The position taken by the State Government is that doctors are greedy and the dispute is being driven by union thugs.
Here is a link to the latest story, in which the rhetorical position taken by the State Government is clearly articulated: Stalling tactics revealed in union’s war plan to prolong Queensland doctors pay deal dispute
The doctors have threatened mass resignations over the dispute. In some disciplines 80% of the specialists have indicated such an intention. The governments response is that they will recruit doctors from overseas. The deadline is 31/3/14 after which doctors who have not signed the contracts will suffer a 30% cut in pay.
All the above is by way of background. What I wanted to post here was a comment made by a QLD doctor on the above story:
I am a doctor who lives in Brisbane and I work as a surgical training registrar for Queensland Health. I am not a member of a union or the AMA. There is currently a crisis in Queensland with regard to the treatment of our most senior doctors by this current government led by Campbell Newman and Lawrence Springborg.
I was educated in Brisbane and am a parochial Queenslander. Upon completing high school in 2001, I moved to Sydney to undergo 6 years of medical school at the University of New South Wales. Upon completion in 2007, I chose to return to my home state to commence my internship in 2008 at the Princess Alexandra Hospital. I am 30 years old and still have 3 years of training left.
Right now my job entails:
· 6 month rotations at various hospitals in South East Queensland to train me to be an excellent surgeon
· On call (currently 3-4 days/week) so when your loved ones are ill and attend the emergency department with a specific surgical issue that they get care 24/7
· Caring for all admitted patients under my specialty in the surgical ward
· Attending and managing patients in our outpatient department (Average 30-50 patients in 3-4 hours of clinic time)
· Performing surgical procedures on patients with direct senior consultant supervision in order to learn the craft that is surgery
· Delivery of teaching to medical students, staff who are my junior and my other surgical training colleagues
Without training doctors, the public health system would come to a halt and you would not receive proper 24/7 treatment. Importantly, none of the above tasks can be performed without senior doctor supervision. Without senior doctors, I cannot complete my training. This will leave a huge gap in the care of Queenslanders in the future. I rely on my seniors to mentor me so that in 4 years time when I am in charge of making life and death decisions regarding your health that I make the safest and correct ones. My training college has already told me that they will move me interstate to complete my training. A loss to Queensland.
Right now, the LNP government is trying to enforce contracts on senior doctors that rip away any ability they have to practice medicine independently. There have been no proper negotiations. So what I hear you say? People go on contracts all the time. True. But these contracts are the first step toward the “Americanisation” of our health system where dollars and cents and key performance indicators drive treatment and not evidence or compassion. Imagine being told you have an illness that can’t be treated because it isn’t economically viable? Senior doctors believe in this cause so much that they will walk out of the public health system in April if the government does not return to the negotiating table. The government has vowed to replace these doctors with replacements from interstate and overseas. As you can see above, specialists train for 15-20 years and this void is not going to be filled easily. Interstate doctors won’t work under these conditions, and those from overseas…well we know what happened last time Q Health was full of unaccredited overseas trained doctors.
So what can you do? Be impartial. Mainstream media is not making a big deal of this and Doctors don’t have a proper union to make noise. We haven’t gone on strike. No services have been disrupted throughout our whole dispute. We are not greedy or thugs as Mr Springborg would suggest. We advocate for you the public and want to continue the delivery of quality healthcare for years to come.
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