Bega-based orthopaedic surgeon Chris Phoon. Credit:Albert McKnight/Bega District News "So I thought I would go out and get some." His unorthodox attempt to remedy an equipment shortage was overruled, but the incident has become symptomatic of a larger conflict at the state's newest hospital. Dr Phoon is at the centre of an industrial dispute that has seen the entire orthopaedic surgery team at the South East Regional Hospital walk off the job, leaving an eight-month backlog of patients in the lurch and prompting intervention from NSW Health Minister Brad Hazzard. When Bega Hospital was closed down and staff were moved to the new South East Regional Hospital last year, the upgrade in hospital status came with a downgrade on clinicians' conditions - they were no longer subsidised for working in a rural hospital.

Dr Phoon has refused to sign the new contract, which he said would amount to a 40 per cent reduction in pay because he would lose the rural doctor settlement package that subsidised travel costs and on-call demands. His colleague Matthew Nott has stopped work in solidarity, while the third member of the team has not returned from annual leave. Their strike leaves in limbo about 480 patients waiting for orthopaedic procedures such as hip and knee replacements. The median waiting time for surgery at the hospital is 247 days, and the majority of people on the waiting list are those waiting for orthopaedic procedures. Mr Hazzard has ordered the administration to negotiate with Dr Phoon in an attempt to reanimate the flow of patients through the system, which is currently relying on locum doctors. "My concern as minister is to make sure that the parties resolve this in the interests of patients and we get the orthopaedic surgeons back to work," Mr Hazzard said.

"Patient safety is number one, but number two is to ensure that the doctors and the community feel confident about their relationship with the local health district." Opposition health spokesman Walt Secord said an "extremely unhealthy work environment" had been created at the hospital. "Despite having a brand new facility opened a year ago, the patients in Bega face the ludicrous situation of longer waits at the new hospital than they did at the old, clapped-out one," Mr Secord said. "While the state government and the Southern NSW Local Health District bicker and in-fight, patients suffer." The hospital administration blocked Dr Phoon from using his own bolt cutters and the patient was transferred to Canberra instead, in what the surgeon says is representative of a system "more interested in arse-covering than actually helping people".

Southern NSW Health District said its decision was made with patient care in mind and all equipment and material needed to meet NSW health guidelines. "Surgical equipment is made to exacting specifications to ensure it's fit for purpose and can withstand the high-pressure temperatures and pressure used in the sterilisation process," it said in a statement. "For this reason, it is not appropriate for anything but genuine surgical equipment to be used in surgical procedures." ANU Professor Peter Collignon, an expert in infectious diseases, said in theory it should be possible to sterilise hardware bolt cutters to hospital specifications. He knew of a case in which an ordinary hammer was used to remove a nail from a patient who had had an accident with a nail gun.