Te Whatu Ora claims the changes will ensure the clinical voice is "better heard" in decision-making. File photo. Photo: 123RF
Health NZ's proposal to cut some chief clinical roles is "a declaration of war" on rural and regional hospitals, according to the senior doctors' union.
Other frontline staff are skeptical of Te Whatu Ora's claims that the changes will ensure the clinical voice is "better heard" in decision-making.
There was a huge turnout at a Rotorua Hospital staff hui earlier this month, when Health New Zealand's chief clinical officer Richard Sullivan - flanked by other top officials - fronted up to answer questions on the proposed restructuring.
One doctor told RNZ there was "a clear message" from staff from all disciplines about the detrimental impacts on patients they foresaw from losing local clinical leadership.
"This proposal would be devastating for Rotorua and Taupo Hospitals and the wider Lakes community. Essentially we would be merged with Bay of Plenty and lose significant clinical leadership roles across medical, nursing, midwifery and allied health. We lose autonomy and will have no voice. "
Emergency doctors at Rotorua are currently fighting management's attempts to get them to also cover Taupo Hospital ED, which is even more short-staffed.
The doctor - who RNZ has agreed not to name - said clinical leaders have been telling managers what was needed for many years.
"The problem is that they haven't been listening.
"The elephant in the room is that this is a resource issue, not a clinical leadership issue, and structuring things differently won't change that."
As previously reported by RNZ, the proposed restructuring involves reducing the number of "districts" from 18 to 14, with Lakes merged with Bay of Plenty, MidCentral with Whanganui, Wellington and Hutt Valley with Wairarapa, and South Canterbury with Southern.
Apart from Canterbury and Southern, all existing clinical leadership positions in medical, nursing and allied health would be disestablished - 23 roles.
Association of Salaried Medical Specialists executive director Sarah Dalton, who represents senior hospital doctors and dentists, said the plan represented a "dumbing down" of the clinical voice, particularly in regional New Zealand.
"This is a declaration of war on the small hospitals.
"Some of the proposed mergers in terms of professional leadership that are directly impacting hospitals like Whanganui, Timaru, West Coast, Lakes, Bay of Plenty, which arguably aren't small hospitals, are going to be to the absolute detriment of those places."
Giving staff less than a month to provide feedback suggested Te Whatu Ora was not interested in "genuine consultation", Dalton said.
"I have yet to find a single senior doctor in favour of this proposal, and I would have to say a number of senior managers share our concerns about what is proposed here."
Nurses Organisation chief executive Paul Goulter said the plan contradicted the government's directive for "a stronger local focus".
"We also think that it's outside of what we understood to be the promises that there would not be a reduction in clinical roles. This is a reduction in clinical roles."
Goulter said it was critical that nurses' voices were heard at this time when the sector was grappling with short-staffing and threats to patient safety.
"The consultation document talks about 'strengthening clinical and managerial operational partnership to ensure clinical voice is heard in decision-making'.
"[But] if you unpack that public service speak, it's actually about reducing nursing leadership in the system. And the charts actually show that."
Health New Zealand declined an interview, saying it would not be "appropriate" while consultation was underway.
In a written response, chief clinical officer Dr Richard Sullivan said no decisions had yet been made, but the changes have been signalled for over two years, since Health New Zealand replaced district health boards.
"I want to be clear that the proposed changes do not aim to reduce clinical leadership FTE [full-time equivalent] overall.
"In fact, new clinical leadership roles in midwifery and mental health & addiction at a regional level are being proposed."
The new district chiefs would also have new clinical lead roles reporting to them, who would be the "on the ground 'go to' resource for local day-to-day issues", Sullivan said.
"The key aims of the proposal are to strengthen the clinical voice in decision making and ensuring greater consistency within our clinical leadership across the country."
Consultation finishes 5 November, with the new structure confirmed by mid-December.
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