A surgeon surnamed Lin (林) in a hospital in southern Taiwan recently spoke about severe shortages of operating room personnel, with too few anesthesiologists and nurses, preventing needed operations from being performed on schedule. It is a matter of profound concern, not least because the collapse of the medical system is no longer a possibility: It is happening.
The problems extend well beyond operating room staffing and availability of surgeons. They were first felt in the outpatient care system. After hospitals closed departments and axed non-nursing personnel such as clerical and administrative staff, they had little choice but to ask nurses from different departments to step in and play a supportive role in these functions.
Although hospitals were ostensibly providing nursing staff interdepartmental training, the reality is that it was necessary to fill the staffing shortages, and was a drag on the efficient operations of outpatient clinics, which also increased the risk of mistakes occurring.
The repercussions of staffing shortages do not only affect nurses, they also affect junior doctors. With too few nurses available to provide support, many junior doctors are unable to open up their own outpatient clinics and are having to turn instead to the private market.
In an effort to keep costs down, hospital administrators not only have to restrict overtime hours for nurses, they have to cut down on electricity usage.
Working on the front line of medical care, doctors are one of the groups given no guarantees under the Labor Standards Act (勞動基準法) and are expected to make sure their jobs are carried out. This is leading to the exact same problem that surgeons are dealing with — not being able to provide their services on schedule and having to postpone operations.
The government cannot simply stand by and watch medical services deteriorate in this way. These issues, from the exodus of nurses and the cutting of outpatient clinic staff to the problems with providing essential surgery on time, affect everyone. If we remain silent now, when our parents, or even ourselves, need surgery and discover that nobody is available to operate, who will speak up for us then?
The key to solving the problem lies in investing in and focusing on medical care provision conditions. We need to reform policy to increase investment in medical personnel, increase salaries and improve the work environment. Medical care professionals also need to come together and advocate for a fair and sustainable medical care system.
That requires public support, because the problems in healthcare are not merely the responsibility of doctors and nurses, they involve society as a whole.
The looming collapse of the medical system would affect every Taiwanese. Today, we need to speak out not only for the surgeons, the physicians and the nurses, we need to make our voices heard for every person that plays a crucial role in the healthcare system. If we do not act now, Taiwan’s medical system would have to be placed on life support, with no guarantees that it would survive.
Lu Chun-wei is a dermatologist and assistant professor at Chang Gung Memorial Hospital.
Translated by Paul Cooper
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