18 Oct 2022

No city emergency departments meeting treatment target - Health Minister

From Checkpoint, 5:16 pm on 18 October 2022

No big city hospitals are meeting their target for treating emergency department patients within six hours.
A report into Middlemore Hospital described the emergency department as "dysfunctional, overcrowded and unsafe". 

The report looked into the circumstances of a woman who left the overcrowded ED without being seen, and later died of a brain hemorrhage.

Chair of the College of Emergency Medicine Kate Allan told Checkpoint the issues at Middlemore are being seen at other hospitals too.

Health Minister Andrew Little said there was a lot of stress on the system. 

"We have a lot of emergency departments, there's variability about their performance against that standard," he told Checkpoint.

"I think what is true to say is that the performance against that standard has deteriorated for some time. That reflects just the pressure the system is under at the moment and the number of vacancies.

"But it is quite a wide variety of numbers, depending on which ED you're talking about."

Little said Dunedin was treating about 58 percent of its ED patients within six hours, while Waikato and Palmerston North were treating about 47 percent. 

"In terms of bigger hospitals Waitākere is at 77 percent, Whangārei is at 75 percent... A variety across there, but it's not at the 95 percent [target]," he said. 

Little acknowledged none of New Zealand's big city hospitals were meeting the target of treating 95 percent of emergency department patients within six hours. He said he would not be worried about going to emergency departments in those regions which were more under pressure. 

"You will get seen and treated in ED, but the wait time will be longer... These are up and down, these were coming out of the back of a pretty tough winter for the health system generally and for most hospitals, and so I would expect to see some improvement in those numbers. 

"But really the challenge is not just about EDs. It is about primary and community care, and it is about aged residential care. So addressing the workforce challenges in each of those areas is just as important if we're going to reduce the wait times in emergency departments."

His advice for anyone waiting in an emergency department who is feeling unwell and uncomfortable about going home is to stay put. 

"You might be waiting a little longer, but you will be in the right place. If you do suddenly deteriorate, you are in the best place you can be."

Little said he has been meeting with the Nursing Council, which is talking to Te Whatu Ora and Immigration NZ about what can be addressed to improve the situation, like getting registrations from overseas staff processed more quickly. 

Emergency Medicine doctors welcome Health Minister's acknowledgement of problem

Association of Salaried Medical Specialists spokesperson and senior emergency medicine doctor Elspeth Frascatore told Checkpoint she was happy to hear Little acknowledge there was a problem in the health system. 

"This is a whole-of-system problem... what it is, is a kind of socialised healthcare system that is really struggling at the moment, and we're seeing it internationally. 

"There are multiple solutions that are possibilities, and a lot of that comes down to resource and a lot of that comes down to staff.

"It comes down to money. There are some quick fixes but it's just not as simple as that. It involves really valuing your healthcare system and valuing the health of the nation, and putting that as a really top priority. 

"And a lot of that just comes down to funding. It's not an easy problem to fix."

Dr Frascatore said she was worried for hospital staff. 

"It's a hard job at the moment. And we are seeing nurses moving off to the private sector, or people moving to other professions or leaving for Australia. 

"Obviously we worry for our patients. We see our patients and we want what's best for them. 

"Anybody that comes to the emergency department - I can't stress this enough - will always be looked after and seen. 

"We really do want to provide good care, and we do. It's just we cannot sometimes control that wait time."