The situation is suboptimal. In a competitive international environment for healthcare workers, the public system salaries aren't keeping up with the international competition. The shortages become a self-reinforcing cycle of overwork, burnout, and reduction in hours. The challenges in healthcare access fall disproportionately on the most vulnerable. It's not great.
These problems are not unique to New Zealand. We do, luckily, have many healthcare worker unions, and most of them have leveraged collective action in recent times to dramatically improve their pay scales. The residents' union and the senior doctors unions, so far, have lagged behind – along with a few other groups. Government funding is a zero-sum game, unfortunately, and money for the health system naturally subtracts from an investment elsewhere – or, money for senior doctors subtracts for another aspect of health system operations. The reality, however, is New Zealand does not get to set the value of a senior doctor, particularly with Australia literally on our doorstep and virtually free movement between the two. It will inevitably be necessary to increase funding for the New Zealand system to close the gap.
We had three (mostly) performative strikes last month – although I was not directly participating, since the ED docs were part of the "life preserving care" agreements. We had two longer strikes scheduled this month that have been cancelled due to progress under facilitated bargaining. I suspect we will end up with a new deal soon enough – and, when it comes close to expiry, we will have to examine whether it was improved enough to solve the recruitment and retention issues.
A new government was elected two days ago – it will be interesting to see the actions of the new health minister once he becomes settled.
My personal situation is excellent – but that doesn't apply universally to all emergency medicine, and even less so to many specialty services, and further less so in smaller hospitals/less desirable rural locations.
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