These included that "one intern had been responsible for up to 60 patients", there's "routinely no medical registrar in the emergency department", "inadequate nursing staff" and "unsafe supervision". Loading ASMOF's letter said that, contrary to the NSW government's contract with Healthscope - which says junior doctors are to care for public patients - the young doctors had been "instructed" to look after private patients in the private wards. The doctors' union said the "scale of the problem" coupled with Healthscope's "apparent indifference" meant the situation was untenable. ASMOF said it had given the junior doctors its support if they chose to decline to provide medical care – except for extreme cases - to fully private patients.

It said it would lodge a dispute with the Industrial Relations Commission if it didn't receive a response by midday on Monday. NSW Health's deputy secretary Nigel Lyons called ASMOF NSW president Tony Sara on Saturday afternoon to say the department was committed to addressing all the problems. "He says they are listening and I trust they will do their best," Dr Sara said. "It's a terrible pity it's come to this but we are confident the problems will be resolved." 'There has clearly been a miscalculation of the number of people [using the hospital],' NSW Health Minister Brad Hazzard said. Credit:Dean Osland The two parties will meet on Monday morning.

While Dr Sara is optimistic about the talks with NSW Health, he described Healthscope management as "arrogant, ignorant and probably incompetent in terms of its capacity to run a public hospital". A Healthscope spokesman said the hospital had been working with junior doctors to address the problems, and many of them had been resolved. "We respectfully disagree with many of the assertions made by ASMOF," he said. The letter is the latest chapter in the controversy engulfing the hospital, with staff revealing on the condition of anonymity that wards are chronically understaffed and repeatedly running out of vital drugs and equipment. Under the project deed, the government has step-in powers, but Mr Hazzard said there was no need to intervene.

"It is only day 17, I think it's a case of 'take a deep breath and let the wonderful physicians, doctors, nurses, support staff and supply staff just get on with their jobs'," he said. Loading Labor's health spokesman Walt Secord said there needed to be better oversight of private hospital operators and called for the appointment of an external independent monitor to "keep an eye" on the facility. "I would make the private operator guarantee they are [meeting contract conditions] and if they don't adhere to the proper standards, I would check the contract to see if there are any penalties that should go to the provider," he said. ASMOF's letter gave a glimpse of the immense pressure on junior doctors and the gaping holes in the staff rosters and confirmed reports of a serious undersupply of critical supplies.