Kilda. I'm Chelsea Daniels and this is the Front Page, a daily podcast presented by the New Zealand Herald. Thousands of senior doctors are on strike until midnight tonight after walking off the job yesterday. Their long running pay dispute with Health New Zealand continues, with doctors saying the latest offer represents a real pay cut when recruitment and retention
is critical. Meanwhile, Health Minister Simeon Brown claims they're putting pay and politics ahead of patients after thousands of elective procedures and appointments have been postponed. So what will end this cycle of disputes and strikes and how do we fix our health system that's been in crisis for decades. Today on the Front Page, Asms Executive Director Sarah Dalton is with us to break down the latest in talks
and what we can do in future. What are the main issues driving senior doctors and dentists to strike and how long have talks with the Health New Zealand has been stalled.
There are really two big parts I think to the strike action for our members. One is the staffing shortages and the other is the fact that Health New Zealand has continued to offer real terms pay cuts to our members year on year since COVID. So on the one hand, everyone acknowledges there are significant staff and gaps and a number of specialties and a number of hospitals around New Zealand.
But on the other hand, knowing this, health New Zealand appears to be doing nothing to address retention or recruitment. And the obvious way to deal with retention and recruitment is through better terms and conditions, right, And I guess the other frustration is that while they're crying poor and saying that we've got We've given you all the money we possibly can, we have nothing more to offer to settle terms and conditions for salary to doctors and dentists.
Just in the last twelve months they shelled out over two hundred million dollars on locums, which is effectively tempts. You know, So they do have money, they're just choosing to spend it in interesting ways.
And what are some of those interesting ways?
Well, for example, why would you prioritize.
Letting locum rates go up and up and up for temporary labor who, of course do a good job, but they don't do the whole job, and they're not here
for the long haul. While at the same time you're saying to a salary doctor, no, we're not going to pay you a retention allowance for working in Gisbon or in Vicago, or we're not going to pay a recruitment allowance for guyne oncologists because there are hardly any left in this country that it would be actually cheaper for Health New Zealand and better for the public if they
incentivize salaried work and disincentivized locan work. So the story was that, you know, under twenty DHBs they could drive up the rates, you know, by one hospital competing against another for locums. Yet under a single employer they have driven up the rates as a single employer for locums. So you can earn a huge amount of money by saying, look, I'll volunteer to go and work in this place for
a week or over a weekend or whatever. Yet the people who are there all of the time, running the department, doing the planning, doing the audit, supervising other staff are earning significantly less.
So it does seem a little bit back to front.
Yeah, I was going to say, do a lot of people just forego the salaried work and just go and be like, yeah, I'll do the casual loco work.
Well, that's starting to be the case, and that is what our real worry is. It is already a real trend in psychiatry where there are massive staff and gaps and a number of services will have more locums than salaried specialists on staff now and that's terrible, particularly because in mental health you're often looking for continuity of care. You are looking for the people that are in the
care of our specialist mental health services. You know they do better when they have stable staff who are there to get to know them and work with them. And I'm not trying to diss the people who are working as locums. We know they're doing valuable work and we know that there are a lot of places that can you have to rely on them because of decisions made by DHBs and Health New Zealand about lower and the staffing levels. Effectively, we see there's been a sink England on staffing for some time.
How do senior doctors respond to the claims that their action amounts to quote, putting pay and politics ahead of patients. That's suggested by the Health minister.
Well, that's his job, isn't it. You know, he's a politician. He's playing politics, and that's fine. But our members aren't politicians. They're doctors.
It's really hard for them to take strike action because they are trying to put patients first. They are trained not to walk away from people who need care. But it has reached the point now that the health system is actually on a daily basis preventing them from giving
people the care they need. I guess the term that academics use for this is moral injury, the injury that you suffer when you're actually prevented from doing the work that you're trained to do in the way and so our members spend a lot of time trying to do the least worst thing for patients rather than the best thing.
This understaffing and the health crisis that we talk about has been going on for successive governments. How do we put an end to it fair and square, Because I'm pretty sure that a majority of the public wouldn't mind tax dollars going towards our health system because that's where we go when we you know, we're at our most vulnerable and we need the most help, right, So how does this?
How do we stop this?
I think that's a really great question. I mean, this government, this particular government, loves targets. We don't love the targets they've picked. But if they want to obsess about targets, how about a workforce target or two to go alongside the care.
Targets, because it's I think it's another thing.
You know, it's really hard for hospital staff when they know they're really short staffed, and then they've given all these supposed productivity targets, performance targets that they have to meet when they know that there's no way that that.
Can realistically happen. So some workforce targets would be great. And then I think there needs to be some multi party agreements about the kind of hospital system, the kind of health system that New Zealand is willing to continue to fund and to provide. And if we've got some multi party buy into some health basics, you know, and even health basics are pretty expensive, defining what our health basics? Does that include.
Hips, does that include age, residential care, does it include dentistry which it currently does, and of course you know what services does it include?
What have people got a right to expect and then we could You know, there are people out there that know how to calculate what level of resource, what level of staffing is required, and obviously for a number of people now the question needs to be asked, how close to home can your care be provided. You know, there's a massive growth of Tallyhealth. That's a great supplement to
other kinds of healthcare. But if that's all you're being offered because you happen to live rurally, or because where you live all of the GP practices are full and they're not taking more patients, it is a poor second to face to face care. And I'm not trying to diss tallyhealth and it has its place, but simply as a substitute for in person care, I don't think that's good enough. I don't think that's what New Zealanders expect
their tax dollars to buy. And again, it's a privatized way of providing care because most of that care is contracted out. So you know, we've put out a recent report about how health has been funded. We know that since twenty eighteen, New Zealand has not been submitting its
health resource and data to the OECD. So all of the comparators that are made between us in like countries are rough guesses, they're rough estimates, and they're overestimates because we've also been including GST in the way health spend has been costed, which other countries don't do, so we've been overinflating what's been spent on health in this country. And also now we no longer seem to have the capability within the Ministry of Health to submit the data
for international comparisons. They just seem so fundamental, and it took this recent report that we commission to uncover that people didn't know that that was no longer happening. So we've got some really fundamental things that need to be rethought, I think, by government, by the policy people who advise government, and I think now is a great time for.
People, through community groups and just speaking up directly to let government and opposition know what kind of health system we want, we expect.
You know, senior doctors are wanting to strike. That's going to cause grief to thirteen thousand patients this week, which I don't think is very fair.
But but hang on, they're striking for a reason, right, They don't just do that on a whim.
No sure, but but what they are doing is that they've had a year of negotiations. The Minister said, let's get this resolved after a year, let's go to binding arbitration. That was rejected outright and as a result they're going through to strike. I mean, you just have to remember these are some of the most well paid public servants
we have in the country. You know, they've put another offer from healthyw Zealand on top, just recently another one hundred and sixty million dollars of taxpayer funding to get five and a half thousand senior doctors contracts resolved. Our viewers stay in the bargaining process, go into strikes.
The Minister's also pointed to the average renumeration of senior doctors that's just over three hundred and forty three thousand dollars six weeks and you'll leave in a fully paid six months sabbatical every six years. Now, this wouldn't be the first time that we've seen a minister conflate figures like this. Would you agree?
Well, I don't agree, and I'll start with it's a three month sabbatical after every six years. And many members wrote to us last time he bandied about that three hundred and forty seven thousand dollars number in Setif I was earning that much money, I would not be going on strike. I would not be concerned about where this is going. And I think it's also another cheap line that politicians and some health leaders like to use, is oh, well,
there are international medical workforce shortages. You know, we're in a competitor international markets, So what can we do well, do more than you're doing at the moment. Don't slag off those specialists who we need. Think about what it is New Zealand can do. If we can't match Australian salaries, what could we do that would make people want to stay here or want to come here instead of going
to Australia. Because you know, nearly fifty percent of our medical senior medical workforce comes from overseas, so we have to be thoughtful about how we continue to attract those people and keep them here because we have a heavy reliance on them. We could not run our health system without those people. So the long term solution is to train more doctors in New Zealand, but that's it'll be a lot, very long time.
If ever, that we train enough of.
Our own senior doctors and dentists here, So if we can't match Australian salaries, what could we do differently? Oh, we could staff really generously, right, So you know a lot of our members when I talked to them, they said, you know, I don't used to mind that we were
relatively poorly paid. But the Australian comparison is an important one because so many of them are in Australasian colleges, so they train with groups of people who disperse across both countries, so they're on chatting terms with a lot
of people working in Australia. I didn't used to mind that they earned so much more than us because I had a great work life balance, I had lots of colleagues, I had interesting, challenging work, and people listened to us and they valued our views on how to better run our service, how to better run our hospital, how to better serve our community. Now they feel like they're not heard, they are sanctioned if they speak out. They don't have
enough colleagues. They are really tired, lots of burnout, and they're like, no one listens to me anymore, So I may as well chase more money because there's nothing else left. That is a terrible situation for us to have put those people in. But that is, you know, that is what they will say.
What's next, Sarah?
Look, what I.
Really hope is that we can get some more I was going to say more intelligent engagement across the table obviously, which sounds harsh, but it's been pretty empty right. The only times Health New Zealand has brought even brought an offer to the table, let alone improve it is when we've called strike action. Now, that's pretty blunt and pretty basic. We would have liked to have had senior enough people across the table right from the start to work through
issues with us. Can we talk about staffing levels? Can we talk about where your workforce planning is at? Can we talk about where our collective agreement, where our negotiations fit into that and the short and the medium term. Can we have a conversation about that. Can we have some commitments that we can take to our members that say we can you know, we can give you this now and that later.
Is that good enough? We don't get that.
We get you can have this much, but no more. And also if we give you this much. Don't tell the others because they'll want it to like it's real kindergarten stuff, or they'll say and to make up the difference because they don't want to They don't want to include a settlement that covers the year we've been em bargaining, so no backdating. Effectively, they're saying, instead of that, here's a lump of money, spend it how you like.
Now, that is not what I would call quality negotiations what I would like them to do.
And when we came back the other day and said, well, continuing medical education, it's really important for specialists to maintain currency of their knowledge. That fund, which is to reimburse doctors for the costs of attending conferences, doing courses, making sure that their.
Knowledge is up to date.
That amount hasn't gone up since about two thousand and nine. How about we put a bit more money into that And they said, oh, oh no, we don't think we could do that, you know, or we'd have to.
Go and check. It's like, well, go and check then, you know, go and check now. And I'm consumed because it sounds like I'm bargaining through the media now and I don't want to do that, but it isn't.
It's just very frustrating, you know when we actually would like to have a conversation of like, you don't want to put money on seeing me, can you talk to us about why that is? And you know you don't
want to increase your contribution to superannuation. We know one of the reasons they don't want to, so they make a six percent up to a six percent contribution super is one of the strongest retention things an employer can do, right because it's a shared commitment to sticking around, and they don't want to do it because they don't offer six percent to nurses or allied health workers or admin staff in Health New Zealand. Again, it's like, oh, if
you have that, other people will want it. We don't want to give it to them. Why don't you want to give it to them? They're holding a health system up. You should be offering to match all of our health workers superannuation to whatever the key we say the maximum is. I think it might be up around ten percent. Now, why don't.
You do that? It's only a cost of people choose to contribute that much themselves and it shows value. But we're not having that kind of a conversation. It's a scraping the bottom of the barrel kind of a conversation, you know, And what's the least we can do to make you stop this? That's pretty much the vibe. You know. Our members find it disrespectful, you know, they really it's disheartening. Yeah, yeah, yeah, they just don't like it at all.
Hence here we are with the forty eight hour strike, unprecedented, and our members are really unhappy about it.
You know, they don't want to be doing that. They actually want to be inside working. That's what drives them.
Ask anyone who is in a long term relationship with a doctor who is not also a doctor, and ask them what penalties that has put on their life together and on their family life if they have a family. It's a massive commitment, and medicine really eats people's lives up, you know, it's a huge thing. And I have so much respect for our members and the works they do. You know, the stories that I hear about the works they do, about the path they took to be able to do that work is incredible.
But so much of the time now it's about well, I can't do that work. We should be doing this, we should be doing that, which should be doing this? Can't do it or it's dangerous. You know, our service is dangerous, and that's a terrible thing. People starting to decide didn't want to come to work today. You know, it's too hard, it's too risky. At the same time, trying to give patients confidence that everything's going to be fine.
We're going to care for you. We will do our best, and they do, you know, but it's pretty grim.
Thanks for joining us, Sarah.
Thank you. It's been a pleasure.
That said.
For this episode of The Front Page. You can read more about today's stories and extensive news coverage and at Herald dot co dot nz. The Front Page is produced by Jane Yee and Richard Martin, who is also our editor. I'm Chelsea Daniels. Subscribe to The Front Page on iHeartRadio or wherever you get your podcasts, and tune in tomorrow for another look behind the headlines.