This was originally written about 10 days ago. It has taken that long for the story to break in the media, and even then it is amazing how few questions are actually being asked.
"Well, it looks like the pressure to stay has peaked and is waning fast. Only last week the other guys were trying to persuade me to stay – now they’ve almost all resigned. It’s a long story, going back over a few years (apparently) – and one that I can’t publish until it goes public in the Advertiser. (that’ll really give credibility). Much of this is from talking to various people and piecing it together. Certainly the last few (8 or 9 months) there has been something in the wind.
There is no standard pay for hospital Drs (as in the UK). Each state pays differently, each health service and within that each specialty group has negotiated special deals.
So the Neurosurgeons, who say that they have to respond overnight within a matter of minutes (as opposed to their registrars who probably actually do the work) or people will die, have a ridiculously high wage deal. Vascular surgeons ditto. Emergency Physicians who are actually in the hospital until midnight everynight and still have the on-call commitments get nothing, and in the latest pay round, they are having the supplement for not doing private work cut by 20%. This has affected anyone getting a consultant job in the last 6 months - several colleagues fought this unsuccessfully over Christmas time.
Generally conditions aren’t actually that great. Reportedly there is a Dr at the Women’s and Children’s (WCH) who has been on call since January. I don’t know what sub-specialty, but they were on the local news. I’m told WCH is a funny one – so much publicity and money raised but it all goes on making the kids life more fun, and actually nothing to improve their medical care. There have also been a few suicides in the last couple of years, in which work life may or may not have played a part (but that’s the message coming across).
Throughout the smaller hospitals there are huge problems with bed block. Every morning it’s apparently not uncommon to start with 10-15 patients in the ED who have been waiting overnight for beds. Much of the specialist services (even Orthopaedics, which I find incredible as it is such a core service of a hospital in the UK) is supplied by the RAH meaning patients have to be tranferred across Adelaide and the state, and many inpatients specialties are unabel or unwilling to give much help to the EDs. Which makes it very hard to do your best for the patients.
South Australia, allegedly, has one of the lowest paid group of EPs in Aus. The RAH consultant have been propping up other EDs in the area by doing extra shifts and giving telephone advice.
The last two job ads for the RAH ED (one for extra consultants, one for Jim’s job) have attracted practically no candidates. Regs coming off the top of the training programme are almost all going Interstate, and many more are doing ITU or anaesthetics, thinking “nice lifestyle” and leaving. Hence the pressure on me to stay (I think anyone would have been in the same position, it’s not me specifically).
So as well as feeling extremely hard done-by (rightly or wrongly) by a govt that has negotiated with other Drs, and being alarmed at the lack of staff, all EPs in the public system in Adelaide have been fighting this battle. Unfortunately it came at the same time as the renegotiations with all other Drs. And the teachers are also saying the same, with some quite public support.
So there have been “stop work” meetings held for all public health service Drs. And the govt has not been playing. They are insistent on cutting the 20% (other Drs in other specialties don’t get this, but they are allowed to do private work). They are not listening to the EPs requests – the message coming across is “aren’t you good for working in the Public system – the reward of knowing you are doing all this for less money should be enough”.
Not surprisingly the guys aren’t happy. So come June 30th, there will be pretty much no EPs in Adelaide. That will impact on the trainees who need a certain amount of Supervision for their jobs to stand, and other overseas Docs (which the dept absolutely relies on) whose visas become invalid. The argument for resignation rather than work to rule is that it allows the govt to get other Docs in (from where? – look for the emergency ads on Doctors net and in the BMJ) and place liability on the govt’s shoulders.
So still waiting for it to become public. It’ll be seen as a battle of the Greedy, Selfish doctors against.... well, I’m not sure how the other side will be portrayed. I’m not sure which media mogul owns the Advertiser, but I wouldn’t be surprised if it was Murdoch, so look at the UK papers for an idea, I would guess.
So I’m glad I’m going back. To being paid much less in a crumbling system that’s being sold to the suits to make money for their shareholders."
So resignations have gone in, effective from the 27th June. Who would believe that a Consultant could have a 2 week notice period? Actually who would believe that you could get 50-odd doctors working together. There really must be problem. Rumours have been flying for a while now and it's certainly interesting being the fly on the wallI'll fill in on the rest of the stuff later in the weekend.
Sunset
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