Too Many Anaesthetists On Leave
on Friday, 02 June 2000

• Introduction

• Facts

• Related Information

• Request for Other Information

• Conclusions

• Addendum A

Introduction

If you remember, there was a big hoo-hah because 3 anaesthetists were on leave at the same time and there was no one to cover one single daycare list on Friday afternoon, 02 June 2000. Some even suggested that there were in fact 4 anaesthetists on leave because Dr. Alan Wong was also on leave which was why we couldn't get anyone to cover the above mentioned list.

Facts

1. There are normally 2 open lists (1 neuro/vascular/spinal open list and 1 daycare list) and 4 fixed surgeon lists (Dr. Tan H.M., Dr. Abd. Haron, Dr. Siti and Dr. Delaila) on Fridays.

2. Of the 4 fixed surgeon lists, three surgeons (Dr. Abd. Haron, Dr. Siti and Dr. Delaila) had opened their lists.

3. Therefore, the number of open lists on that day was in fact 2 - 1 + 3 = 4. In other words, the number of open lists had doubled from 2 to 4.

4. Furthermore, as the next day was the Agung's Birthday, many of the other surgeons were also on leave (about 13, I believe).

5. In spite of this, Ms. Irene Quah, in her infinite wisdom chose to kick up a big fuss about the lack of coverage for that one single daycare list.

6. As it turned out, there was hardly any work on that Friday afternoon and one other list had to be closed.
   

   Anaesthetist	Surgeon	Procedure
   Chan	J Tan HG	Tonsillectomy
   Tan PH	Govindan	Laparoscopy Cholecystectomy
   	E Peter	Fissure-in-ano
   Radha Krishna	Siti	Frozen ET
   Ngun KW	Tan HM	TURP
   	Tan HM	URS
   Mary	Abd. Haron	No cases
   Bachan S	Daycare	Closed

7. As you can see, of the 4 lists with any cases at all, 2 of them would be expected to finish within 30 minutes. The other 2 lists had 2 cases each, both of them medium to small cases. Not one of the lists could, by any stretch of the imagination, be said to be full or even nearly so.

Related Information

The hospital has had to close its OT's and wards at various times in the past due to too many  nurses being on leave at one time and also in anticipation of a fall in workload due to the fact that many doctors including surgeons may have gone on leave at the same time. This had generally occurred during long holiday periods where many staff were on leave and patients often preferred not to have their surgeries then, as well.

While the closures mentioned above might have resulted in a loss of income to those anaesthetists who were not on leave, never at any time did the anaesthetists (nor any other consultants, as far as I am aware) complain that the hospital should not close the wards or operating theatres. We all understood that,

1. There are times when it is not possible for the hospital to maintain the same level of service throughout the year.
2. Certain times of year can be expected to have a lower workload and it would be logical for doctors and staff to take leave during these periods.

Request for Other Information

If you have other documents or information to support our view, perhaps similar to the evidence in the section above, I would most appreciate it if you could pass it over to me.

Conclusions

1. The work on Friday 02 June 2000 was not in the least affected by the closure of the daycare list as had been expected by all the anaesthetists.
2. There will be times when either the hospital or the medical staff may not be able to provide the full level of service as they normally can. However, as long as, as much care as possible is taken to ensure that the health and safety of patients are not affected and that leave is taken at times where the workload is expected to be low, then there should be no objections to the occasional inability to maintain the normal full service.
3. Where possible, adequate warning should be given to ensure minimum disruption of services.

Addendum A - More Ammunition

1. Closure of ENT/Gynae Ward - North Tower and Reduction of OT Services
   23 December 2000 to 1 January 2001
2. Closure of Surgical B Ward - North Tower and Reduction of OT Services
   21 January 2001 to 28 January 2001