Fiji confronts doctor shortage issues

The Fiji Medical Association says there is a doctor shortage in the country due to 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 says a whole range of retention strategies, such as pay, conditions and the number of hours doctors work need to be looked at.

He said stakeholders need to come together to work out ways to retain senior doctors and ensure junior doctors want to stay in the system.

“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.

“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.

“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.

Dr Fong said they are currently looking at 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.

“I think that there needs to be a forum 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.

“The area of improvement the government has to work on, it is the strengthening of retention measures so that we can ensure that the people who are around stay and mature within the system, long enough so they have the capacity to want to supervise the younger ones coming through.”