Speaker A
We've just finished doing the operation on the last patient, and I'm just finishing up and heading home.
Dr. Tom Morrison reveals the crisis in NSW public health, highlighting unsafe working hours, strikes, and calls for better pay and conditions.
Key Takeaways
- Unsafe working hours and understaffing in NSW public hospitals endanger both doctors and patients.
- Doctors' strike highlights critical pay and working condition disputes with the government.
- Improving healthcare efficiency and reducing waste is essential alongside fair compensation.
- Mental and physical health of junior doctors is severely impacted by current system demands.
- Systemic reform requires balancing funding, staff welfare, and operational efficiency.
Summary
- Dr. Tom Morrison, a neurosurgery registrar, describes exhausting shifts exceeding 30 hours and the toll on doctors' health and patient safety.
- NSW Health faces a crisis with hospital closures, medical staff strikes, and widespread resignations amid poor working conditions.
- In April, 6,000 doctors, including union VP Morrison, staged a historic three-day strike demanding safer hours and pay parity with other states.
- Doctors seek a 30% pay rise and guaranteed 10-hour breaks between shifts; the government offered just over 10% over three years.
- The NSW Health Department threatened doctors with professional misconduct investigations for strike participation, escalating tensions.
- Junior doctors report severe stress and health issues caused by demanding workloads, including dehydration and sleep deprivation.
- A special commission is investigating healthcare funding, with experts suggesting efficiency improvements rather than just pay increases.
- Research shows 60% of healthcare is high quality, 30% waste, and 10% harm; improving these ratios is crucial for system reform.
- Doctors express feeling complicit in patient harm due to inadequate services and unsafe working conditions.
- The emotional and physical strain on junior doctors includes dangerous fatigue, risking their safety while commuting.
Full Transcript — Download SRT & Markdown
Speaker B
As a neurosurgery registrar, Dr. Tom Morrison operates on the brain and spine.
Speaker B
His shift was supposed to end at 3:00, but today he hasn't got out until 6:00.
Speaker B
Two hours later, an emergency.
Speaker A
I am back in the hospital to do another emergency operation.
Speaker A
Unfortunately, not quite as quick as I would have hoped, but home time.
Speaker B
Dr. Morrison is on call throughout the night, and it's not long before he gets woken up.
Speaker A
There's a patient in emergency who's acutely unwell.
Speaker A
Just walking through the ICU.
Speaker A
I'm somewhat fortunate that that was a shorter trip.
Speaker A
So I've got some chance to get some sleep before tomorrow morning.
Speaker B
The extra overnight work is on top of Dr. Morrison's regular day shifts.
Speaker A
Got about four hours or so of sleep, and now having a bit of breakfast.
Speaker A
And I'm on my way back in, it's about 10 to 7:00, just heading to the office.
Speaker B
This is the life of a public hospital doctor, where things get out of hand quickly.
Speaker B
Tom Morrison says he recently had to work 32 hours straight.
Speaker A
I think you're kidding yourself if you think that you're operating at your best throughout that period of time.
Speaker A
You just can't.
Speaker A
You make mistakes.
Speaker A
You get tired.
Speaker B
New South Wales Health is in crisis.
Speaker B
With hospital department closures, medical disasters hitting the headlines, and ongoing strikes and resignations by nurses, psychiatrists, and doctors.
Speaker B
In early April, 6,000 doctors, including the union's junior vice president, Tom Morrison, walked off the job for three days.
Speaker B
It was the first doctor strike of its kind in the history of the state.
Speaker A
This might be the beginning, but it's certainly not the end.
Speaker A
We're going to take it to them all the way.
Speaker B
Is it possible that patients have been harmed because of the strike action?
Speaker A
We know of no instances where any patient has suffered harm, and we did not change or take any inaction that would impact an emergency service.
Speaker A
Certainly has been delays to elective surgery.
Speaker A
And non-urgent appointments.
Speaker A
And we we don't want to take industrial action.
Speaker A
However, we thought the system was so catastrophic and those harms were occurring as business as usual, that we needed to do something to change it.
Speaker B
At the center of the dispute, an impasse over pay and conditions.
Speaker B
The doctors want a guarantee of 10 hours break between shifts and to be paid on par with other states.
Speaker B
That means a 30% pay rise.
Speaker C
A 30% increase for doctors is about a $116,000 increase in salaries, and I would have to jack up taxes for regular mums and dads by a massive amount.
Speaker C
$11 billion over four years to meet that demand.
Speaker B
Instead, the Minns government offered just over a 10% pay increase over three years.
Speaker A
We've had no progress on these issues.
Speaker B
Do you think that perhaps those demands are too ambitious?
Speaker A
Well, I don't think it's ambitious to be asked to have fit safe working hours.
Speaker A
I don't think it's ambitious to not have to work 30 hours.
Speaker A
And treat patients.
Speaker A
And I don't think it's ambitious to be asked to pay the same as every other state.
Speaker B
Days before the strike, the dispute intensified.
Speaker A
This is an email that New South Wales Health sent to every doctor who works in this state, which essentially describes that a thinly veiled threat.
Speaker A
That you're going to be referred to Apra, the medical regulator and the medical board of Australia.
Speaker A
These are bodies for serious professional misconduct.
Speaker A
Not for people who are standing up saying we're working in an unsafe system.
Speaker B
And what was the your colleagues' reaction?
Speaker A
Very similar to mine.
Speaker A
People just were astounded that there's been such a dramatic escalation.
Speaker B
The Health Minister declined 7:30's request for an interview.
Speaker B
And he didn't respond to our questions.
Speaker B
Instead, pointing to previous press conferences.
Speaker D
First week working as a doctor.
Speaker D
We worked 62.5 hours done at a whopping $38 an hour.
Speaker B
Dr. Fahad Khan expected hospital work would be hard.
Speaker B
But when he realized just how different his conditions are to his colleagues interstate, he took to TikTok.
Speaker D
Who would want to come to New South Wales when you can go literally anywhere else and get a better deal?
Speaker B
For the time being, Fahad Khan is sticking it out in New South Wales, where being a junior doctor, he says, can become demoralizing.
Speaker D
There's just some really ugly things that the public isn't aware about.
Speaker D
When I was a medical student, um, and in a Western Sydney hospital, there was a junior doctor who got kidney stones twice because he wasn't drinking enough water.
Speaker B
Because he didn't have time to drink water?
Speaker D
Correct.
Speaker D
I had another doctor who basically um shared with me that when they went to bed and they woke up in the morning, they were so stressed that they actually wet their bed.
Speaker D
What sort of conditions are we putting our doctors through?
Speaker E
Healthcare is like a black hole.
Speaker E
You could pour dollars into it.
Speaker E
And not reach the bottom.
Speaker B
A special commission of inquiry is looking at how we can better fund our healthcare system.
Speaker E
But the current envelope of money, about 9.3% of gross domestic product, at 9.3% of GDP, um isn't really going to get much higher because there's so many pressures on the budget.
Speaker B
Professor Jeffrey Braithwaite is a member of the inquiry's expert panel.
Speaker B
He says that paying doctors more money may not fix the problems.
Speaker E
I think there's a case for them to be paid more.
Speaker E
One of the problems with more pay is there's a little honeymoon effect when you get your pay increase, but after that, you just reckon you deserved it.
Speaker E
And that's what you're worth now.
Speaker E
So it's only a sugar hit.
Speaker B
Professor Braithwaite's research on modern health systems, including New South Wales public hospitals, found that most of them can be run more efficiently.
Speaker B
He found that 60% of healthcare is high quality care, 30% is a waste of services, like unnecessary tests, and 10% is actual harm to patients, accidents and mistakes.
Speaker B
Shifting those numbers, he says, is key.
Speaker E
If you get more high quality care, more care in line with the guidelines and the evidence, less waste, less harm, you can have a better health system.
Speaker E
That comes free.
Speaker E
But it has to be delivered, and these numbers have remained fairly sticky for a couple of decades.
Speaker B
A doctor's submission to the special commission into health funding included some chilling testimonies.
Speaker F
I feel complicit in harming patients because of the inadequacy of the service we provide.
Speaker F
My clinic is unsafe because there is so much urgent demand and not enough time.
Speaker F
If it's not urgent, it doesn't get done.
Speaker D
Within about 5-10 minutes of driving, I feel like I was starting to have micro sleeps, so I started like actually nodding off while I'm at the wheel.
Speaker D
And that's like a warning sign for me to get into a spot that I can have a nap.
Speaker D
I just think it's very disappointing that like this is the reality of the situation where junior doctors have to, you know, collectively have a plan on how to not die when you're driving home.
Topics:NSW Health crisisdoctor strikepublic hospitalworking conditionsjunior doctorshealthcare fundingpay disputemedical workforcepatient safetyhospital efficiency
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