Fifty senior doctors at Hawke's Bay District Health Board have warned board members that chronic shortages of beds, staff and delays in elective surgeries are putting patients' safety at risk.
The consultants called an urgent meeting with the board last week and met with the chair Kevin Atkinson and four other board members, to speak out about what was going wrong.
The list included concerns about hospital capacity, patient flows and long waiting times for elective surgeries resulting in more complex cases and longer stays in hospital.
Both Mr Atkinson and deputy chair Ngahiwi Tomoana were at the meeting but had since travelled overseas and were unavailable for comment.
Board member Barbara Arnott, who was also there, said while the DHB was well aware of pressures within the hospital the meeting was a wake up call.
"ED talked about going from 30,000 presentations to the Emergency Department to 50,000 presentations in a very short amount of time and that pressure means electives fall off the bottom.
"The board knows very well that we are not doing enough electives and there are people who are not getting the treatment they need."
Despite these pressures, patients' safety was not being compromised, she said.
"It is not. We are going to have continuing discussions with them [doctors] about how we can make quick changes that will ameliorate the situation for them and patients in Hawke's Bay," Mrs Arnott said.
However, the Resident Doctors' Association said patients were only being kept safe by hard working senior and junior doctors, some of whom had double the usual number of patients to look after because resources were so stretched, national secretary Deborah Powell said.
"Fortunately we have very good doctors... but it doesn't stop those guys from worrying that they might make a mistake or something might happen."
Consultants were so busy that many patients were not seen within the 24-hours recommended time frame and junior doctors often did ward round alone with no supervision, Dr Powell said.
"They're treating them as best they can without that senior consultant review, which is not adequate."
"We have more patients than we can cope with. At the moment our medical teams are consistently having to manage more than 20 patients, which is a very, very high number. At the same time there is a shortage of staff. It is quite a dire situation in Hawke's Bay."
Ms Arnott said the district health board would investigate these concerns and, in mean time, changes would be made to ease congestion at the hospital.
These included putting more beds in wards, extended operating theatre hours so more surgeries could be done each day, and increasing staffing for both doctors and nurses. Ten medical beds and a surgical assessment unit would also be set up.
Consultants also expressed dissatisfaction at the meeting with chief executive Kevin Snee's failure to deal with their previous warnings but Ms Arnott said he had full confidence of the board.
"Yes they do. And the board will hold management to account in terms of ameliorating [senior doctors] concerns," Mrs Arnott said.
Ministry of Health chief executive Dr Ashley Bloomfield planned to meet with Hawke's Bay consultants to talk through their concerns but a date for his visit had not yet been set.