Shortage of skilled doctors in Fiji

Transcript

The Fiji Medical Association says a doctor shortage in the country is a result of skilled, senior physicians leaving for better opportunities overseas.

Its president, James Fong, says the government has been effective in creating new jobs for doctors and nurses, and increasing the number of graduates.

But he says a lack of senior physicians means the level of care can be compromised, and junior doctors starting work are not being properly mentored.

Dr Fong told Mary Baines stakeholders need to come together to work out ways to retain senior doctors and ensure junior doctors want to stay in the system.

JAMES FONG: We've all harped on about this issue for quite a while. There is a doctor shortage. More recently they are trying to fix it by increasing the number of graduates, however the main shortage remains at the very senior level, amongst the senior people, senior clinicians, people who have worked a long time and are mature within the system and have the capacity to mentor and supervise the younger ones coming through, that's where most of the limitation is.

MARY BAINES: There are a lot of junior doctors, graduates, coming through and not so many seniors, as you've said. So why has this happened?

JF: There has been quite a lot of out migration, people have been leaving the system for greener pastures and feel there are better options outside of Fiji. We are well aware in the Fiji Medical Association that this is not something that Fiji alone suffers from. I must say that from what we see the numbers leaving the system have somewhat declined over the last four or five years, but we have never caught up with the out-migration and the loss of skilled staff that had been happening prior to that. In most countries around the world, Australia, New Zealand included, the colleges usually set up good, mentoring structures that will allow the young people to come through and be supported in the environment they work in. We have the basic structures to do such a thing but we just haven't got the maturity within the system yet to do it properly where we can support all the young doctors as they come through.

MB: So what needs to be done to retain senior doctors and make sure junior doctors are being properly mentored?

JF: We have to look through a whole range of retention strategies. Doctors will need to look at their working hours a little bit more, people need to be paid better for the number of hours they have worked. Rather than look at their base salaries, we need to look at the condition in which they work. There needs to be some better capacity in place for appropriate negotiations with clinicians into how the service is being developed, so that there is a sense of ownership, so that clinicians, the people who work the system, feel that they own the system. That requires a little bit of sophisticated thinking.

MB: Is that your job or the government's job?

JF: I think that there needs to be a forum that is to be set up to try and ensure this. There needs to be a number of partners, stakeholders. We cannot expect just one person to do it. I would expect that the Ministry of Health would need to take the lead role in it so that we can make sure that all our services are nicely planned so that resources are moving where they are most needed and so that the services that people need the most are the ones that they get and not the services that have a higher profile. If there is any area of improvement the government has to work on, it is the area of strengthening retention measures so that we can ensure that the people who are around can stay and mature within the system long enough so they have the capacity to want to and supervise the younger ones coming through.