HALF of Adelaide's emergency department doctors have quit in a dramatic move that threatens to throw the state health system into chaos.
At least 44 doctors from metropolitan hospitals, who are seeking a pay rise of up to $111,000 a year and improved conditions, yesterday told the State Government they would walk off the job in two weeks.
The move, following months of bitter pay-and-conditions negotiations, prompted Health Minister John Hill to accuse them of "blackmail".
Mr Hill said the doctors' union, the SA Salaried Medical Officers Association, had used a similar "tactic" last year when psychiatrists threatened to quit, then withdrew their resignations at the last minute.
"This is, in my opinion, an outrageous piece of blackmail," he said. "It is really effectively the union pointing a gun at the heads of patients in our public hospital system in SA.
"It is a tactic I think is despicable because it threatens the circumstances of many patients in SA.
"It is really effectively trying to blackmail the patients of this state."
It is understood up to 30 anaesthetists from public hospitals also could hand in their resignations today.
The health system is facing a further blow because up to 200 rural doctors are threatening to resign over changes to country health.
If the metropolitan emergency department doctors carry through with their resignations, hospitals would be forced to turn away the least serious cases or rely on more junior staff, threatening patients' safety.
Mr Hill said the Government was considering "contingency plans" such as diverting some patients to general practitioners.
Enterprise-bargaining talks between the Government and doctors began about eight months ago and have stalled several times since.
In April, about 300 doctors said they would consider resigning over the impasse.
The Industrial Relations Commission is dealing with the dispute and a meeting was held with emergency department doctors last week.
The State Government says it is offering to increase the current annual package for emergency department consultants from about $313,000 to about $356,000. However, it says SASMOA wants almost $425,000.
The packages on offer include on-call allowances, leave loading and salary sacrifice benefits.
"We are offering a very fair and competitive wage package to the doctors. We believe it will make them amongst the highest-paid in Australia," Mr Hill said.
But the Australian Medical Association says those figures represent only the very top level of wages.
Join the debate: Who is in the wrong? The doctors or the Government?
"There would be very few doctors who would meet that figure, and it's all very well to claim that the doctors may achieve certain incomes, but the reality is that . . . the few who do would be the most senior," AMA state president Dr Peter Ford said.
Dr Ford said the doctors were not making idle threats and they would easily find other positions.
"I think we have to take their word that they are serious," he said. "It is a sad day for health in SA to see the situation develop as it has. I think it's going to put huge pressure on the front of hospital where emergency physicians do their important work and that will have to be picked up by other people in the hospitals."
SASMOA senior industrial officer Andrew Murray last night said overcrowding and under-staffing in the emergency departments were creating "already life-threatening situations".
"To be blunt, it would be a good time not to be a patient," he said.
The Rural Doctors Association of SA said up to 200 rural doctors could quit if the Government's new Country Health Plan was adopted. Under the plan, released a week ago, about two-thirds of country hospitals will have their services reduced.
RDASA president Dr Steve Holmes said 43 hospitals had been "earmarked to turn into first aid posts" and doctors would move interstate rather than stay in that situation.
Port Broughton GP Dr Alison Edwards said she would resign if the cuts were implemented.
"I will be able to treat my patients but not be able to admit them to hospital locally," she said.
"I have placed my hospital on notice that it's my intention to resign if the Health Care Plan proceeds in its current format because I cannot offer continuity of care."
Mr Hill said rural doctors had "misunderstood" the details of the plan and the vast majority of rural residents would be better off.
Opposition Leader Martin Hamilton-Smith said the Liberals, the RDA and the Rural Division of General Practice had united to condemn the cuts to rural health.
"The Government has alienated city doctors over poor wages and conditions and now has insulted hard-working country doctors by downgrading their hospitals," he said.
"The case for scrapping the $1.9 billion Marj and investing that money in doctors, nurses, regional health and cutting hospital waiting lists is overwhelming."
Well I hope NSW doesn't follow suit!
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