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RNZ News
2 days ago
- Health
- RNZ News
Dargaville Hospital loses its only full-time doctor
Dargaville Hospital has lost its last full-time doctor. Photo: RNZ / Peter de Graaf Dargaville Hospital has lost its last full-time doctor, the latest setback in a staffing crisis affecting many rural hospitals around the country. Health New Zealand said the doctor's departure is unfortunate, but it has enough staff to keep the hospital running on the current roster, and there won't be any change to staffing levels in place since late last year. The 12-bed Northland hospital came close to shutting down last October when it could no longer find enough doctors to fill the 24-hour roster. The inpatient ward now runs without a doctor most nights. Instead, overnight care is provided by nurses backed up by a telehealth service, in which a doctor at another location offers advice via phone or video call when needed. Hopes of returning to 24-hour medical cover slipped further out of reach at the end of June with the loss of the hospital's only remaining full-time doctor. Rural medicine specialist Josh Griffiths, a member of the ASMS doctors' union, said the hospital now had two-and-a-half full-time-equivalent (FTE) doctors, when four were needed. "We were already not in a great place, staffing wise. When she was here, we were down to about two thirds of our job-sized FTEs. With her gone, that takes us down to about half." Dr Griffiths said the doctor's departure was a blow because she was committed to Dargaville - she had even bought a home in the town - and had specifically sought a position in rural Northland when she was recruited from the US about three years ago. Dr Griffiths said the remaining doctors were doing extra day shifts to fill the roster, but that was balanced by fewer night shifts now the hospital no longer had a doctor on duty 24 hours. They had, however, hoped to return to 24-hour cover at some point. "This just takes us a step further away from reinstating full services, which is really disheartening," he said. Dargaville Hospital serves about 27,000 people living in the town (pictured) and surrounding Kaipara District. Photo: Peter de Graaf/RNZ Mike Shepherd, acting deputy chief executive for Health NZ's northern region, said Kaipara residents continued to receive the same level of service from Dargaville Hospital as they had since November. "We have received the resignation of one of our doctors and clearly that's unfortunate, but we continue to have enough doctors to staff the roster without impacting the service for patients," he said. "We're continuing to actively recruit to further staff, as you'd expect, and we don't anticipate any change to service to the community." Shepherd said Health NZ had yet to decide whether to try to reinstate 24-hour cover. "We're having that conversation... Our priority at the moment is to continue to provide what we are providing. We think we're providing a good service during the day, and a safe service overnight using the range of treatment and staff that we have." Shepherd said the number of calls nurses were making to Emergency Consult, the hospital's telehealth provider, had decreased as they became more skilled at managing issues in the ward overnight. Meanwhile, Dr Griffiths said he had mixed views on telehealth. He believed it was safe and essential, because it was filling a gap that could have otherwise forced the hospital to close. "But it doesn't always work out great for patients. We now transfer anyone unstable to Whangārei but that means a massive increase in the use of ambulance transfers, which is a problem for St John who are also struggling with staffing in rural areas. It's also problematic for patients who want to be cared for close to home." Dr Griffiths said it also put extra strain on Whangārei Hospital, because patients that could have been treated in Dargaville were now sent there. Another problem was that patients who were not particularly ill could not be sent home because they could not be fully assessed overnight. "So they're either transferred to Whangārei or kept in Dargaville overnight where they can be monitored, and the next day the doctor has an increase in workload because stuff's been deferred from overnight... So, it's safe, but it's clearly sub-optimal, and a lot of patients tell me that they're dissatisfied because they can't really be dealt with by telehealth, they're just deferred or transferred." Dr Griffiths said he was "really proud" of the way Dargaville's nurses had stepped up. "It's resulted in a lot of upskilling, and nurse management has taken a proactive stance by trying to get people through courses to educate them more on managing emergencies in a way they wouldn't have had to previously, because the doctor would have taken the lead," he said. "Some of them have taken to it really well. Others are not really happy because it's different to what they signed up for. I'm also worried about our senior nurses, because they're compensating for the lack of doctor cover by being on call for critical issues 24/7, and sharing that amongst themselves." Dr Griffiths acknowledged that recruiting doctors was difficult worldwide, not just in Dargaville. "But I do think there are specific things that could be done better, which we've pushed for, and we've had a really lacklustre response." In particular, he said Health NZ should increase the rural recruitment and retention bonus paid to doctors who took up jobs in hard-to-staff places like Dargaville. As for the improved after-hours medical service promised in May by Health Minister Simeon Brown, Dr Griffiths said it was a positive move, but he was surprised no one at the hospital had heard about it before the announcement. He hoped officials would talk to locals and find out what was needed, rather than impose a top-down solution. Brown told RNZ the $164 million programme to expand and strengthen after-hours healthcare across the country would be rolled out during 2026 and 2027. He said Health NZ was currently considering the model and specific timing for the service. Within Northland, better after-hours access would be provided in Dargaville, Hokianga, Kaikohe, Kaitaia, Kawakawa, Mangawhai and Waipapa. Health NZ was also working on improved access to daytime urgent care in Dargaville, he said. Brown said he also expected Health NZ to continue recruiting clinical staff for Dargaville Hospital. "I have received assurances that Health NZ are doing so, and that existing services for patients will be maintained while this is underway," he said. Dargaville Hospital serves a population of about 27,000 people. The nearest secondary-level hospital is at Whangārei, about an hour's drive away on State Highway 14. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
RNZ News
23-07-2025
- Health
- RNZ News
Delays at Nelson hospital becoming "dangerous"
health infrastructure 28 minutes ago Ageing infrastructure, persistent delays in recruiting staff and an increasing demand for services have been identified as some of the issues facing Nelson Hospital. A review was commissioned after several doctors spoke to media about their longstanding concerns over staffing and patient safety. But it stopped short of explaining how these problems would be solved. Anaesthetist at Nelson Hospital and the president of the Association of Salaried Medical Specialists, Dr Katie Ben spoke to Melissa Chan-Green.
Scoop
23-07-2025
- Health
- Scoop
Nelson Hospital Review Fails To Hold Leadership To Account
The review of Nelson Hospital released by Health New Zealand today is little more than a 'plan to make a plan' the Association of Salaried Medical Specialists says. The review just restates well-established problems with leadership and severe understaffing at Nelson Hospital which are causing delayed care for hundreds of patients. The Nelson Review was commissioned after Senior Medical Officers spoke to media in March about the poor working conditions. Doctors, fed up with inaction, described massive wait times for first specialist appointments, and repeated refusals from leadership to address staffing shortages across many departments. This prompted Health New Zealand's chief clinical officer Richard Sullivan to commission a review. He said, "I would hope we will have some answers within weeks." "Four months later and all we have is a a plan to make a plan," ASMS executive director Sarah Dalton says." Doctors, nurses and patients want solutions to these ongoing problems, not a bland description of known issues leadership should have addressed years ago. "The review lacks timeframes, holds no leaders to account for these failures. Just last month Nelson Hospital was again in the news for booking "ghost clinics" in what appears to be an attempt to game the system in regard to first specialists' appointments numbers. "There is a worrying trend of poor management and poor leadership at Nelson Hospital which the review fails to address."ASMS is disappointed there has been little engagement with hospital staff - and no consultation as to the review's findings and recommendations. "We understand regional deputy chief executive Martin Keogh and National Chief Clinical Officer Dame Helen Stokes-Lampard presented the report to just a handful of senior staff and gave other staff just 24 hours' notice to a 30-minute briefing. "This is a wasted opportunity to make positive change," Dalton says the real finding from the review is that the issues at Nelson are present in other hospitals around the motu. "The review uses comparative data that paints the dire picture of medical staffing gaps in similar sized hospitals across the country too. This aligns with our own findings. We simply need more doctors," she says. "Short staffing and increased acute patient demand, coupled with a lack of accountability from our health leaders that allow hospitals to be so poorly staffed has bred a culture of getting by instead of getting ahead." Additional information ASMS has been working with senior doctors and managers to conduct in job-sizing activities independent of the Nelson Hospital Review. The following are findings from these activities: - ASMS has completed 17 service reviews (job sizing) across the Nelson Marlborough district since are nine further services still to assess. - Our findings so far - which Nelson Hospital management has accepted - show these departments are short a total of 48.7 senior medical officers. - Only 14.7 vacant SMO roles, identified in job sizing, are currently budgeted to be replaced. - Nelson and Wairau hospital district do not provide recruitment or retention allowances, or "public-only" allowances to senior medical and dental staff. This measure would help fill vacancies. - Senior doctors are routinely working beyond their contracted FTE with large amounts of unpaid overtime being gifted to the hospital to fill staffing gaps. Leadership is aware of this. - Senior doctors are not being allocated their non-clinical time (this is non-patient facing work, including teaching, planning, audit, research, and the like) due to the acute patient load and short staffing. - Nelson district has been in breach of its obligation to have formal recovery time arrangements since 2020. This measure allows senior medical staff to safely recover after working overnight calls. The district has been in breach of this SECA clause since 2020 with most departments having no formal arrangements in place. - All reviewed services are currently understaffed Services we've reviewed to date (job-sized): Nelson anaesthesia , Child and adolescent mental health services, Cardiology Nelson general surgery, Nelson ED, Wairau ED, endocrinology, Nelson general medicine, Wairau general medicine, Nelson pediatrics, Wairau pediatrics, respiratory, Nelson O&G, Wairau O&G, older persons' health, vascular surgery, neurology
RNZ News
08-07-2025
- Health
- RNZ News
Senior doctors' union welcomes Health NZ U-turn on axing Wellington Hospital maternity beds
Photo: RNZ / REECE BAKER A senior doctors' union says it's frightening how close Health New Zealand came to axing a section of maternity beds at Wellington Hospital. Health NZ announced on Tuesday it would no longer use maternity and gynaecology beds for emergency department overflow, after RNZ revealed the proposed trial on Monday. The news was welcomed by one expectant new mum as well as senior doctors' union the Association of Salaried Medical Specialists (ASMS), which said the U-turn was the right decision. ASMS industrial officer Jane Lawless said Health NZ could not fix a crisis in New Zealand's emergency departments by creating crises in hospital wards. "We had a similar problem late last year at Mid-Central [Palmerston North Hospital] when ... there was an intention to just start moving ED patients into ward corridors. "We had to push back really hard and get them to understand from an evidence-based point of view why that really wasn't going to be a solution. "Everybody's concerned about the ED crisis but that doesn't mean that you create new crises in an attempt to solve that." Lawless said the way the Wellington situation had been handled was "of great concern". "I think we can be quite confident that there wasn't adequate consultation and when you look at the reaction from clinical staff I think that bears that out as well." Lawless said all hospital patients were vulnerable but the potential impact of the proposal was conveyed to her by a hospital doctor. "She said if a baby doesn't have the care it needs in the first hours of its life and it ends up with a catastrophic brain bleed - well that's a disability for life. "She was just pointing out how close to the edge things are and therefore how extra cautious we need to be when we make changes to models of care." Lawless said clinicians had plenty of thoughts about how to resolve some of the pressure in ED but they were not necessarily being heard. First-time mum Ashley Godwin said she was so worried about the proposed trial she considered giving birth at another hospital. "I was messaging a few friends being like 'Oh should I consider going and having the baby somewhere else where I know that there might be a little bit more support afterwards' or, you know having to prepare for that conversation with my midwife on Friday of what happens if I do get kicked out straight away or if I turn up for an induction and they delay that by a few days 'cos there's not enough beds. "So I definitely have felt a huge sense of relief with the announcement." She commended Health NZ for listening to clinicians, midwives and the public over their concerns and said the news was a weight off her mind. "When you're thinking about being in labour and going into the birthing unit, and what that looks like post-birth, not having to worry about the fact that you might get kicked out straight after having a baby not knowing what you're doing, not having that breast-feeding support or just not having the proper time to recover before going home, [the turnaround] just makes the whole experience a little bit more bearable in the coming weeks." Health New Zealand Capital, Coast and Hutt Valley group director of operations Jamie Duncan said in a statement the trial to "reallocate unresourced maternity and gynaecology beds" at Wellington Hospital would not proceed. "We understand the importance of these services to women and families across the region, and after careful consideration of feedback from a broad range of stakeholders, the proposal will not continue." Duncan said Health NZ remained committed to "optimising the use of all available beds across our facilities, particularly during peak periods when demand increases significantly". "We will continue to work with our staff and clinical leaders to explore sustainable ways to enhance patient flow and improve access to timely care for all patients, while ensuring the specialised support that maternity and gynaecology services require." Duncan said patients were at the centre of every decision made. "We will continue to work closely with our clinical leaders and teams to ensure the best possible outcomes for women accessing maternity and gynaecology care." Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
RNZ News
19-06-2025
- Health
- RNZ News
Private hospitals' use of publicly-funded cancer drugs will widen inequities, warn doctors
Under 'transitional access' private patients won't have to shift to the public system for 12 months. Photo: 123RF A move to allow private patients to access publicly-funded cancer drugs threatens to increase wait times for those in the public system, warn senior doctors. Under "transitional access", which comes into effect on 1 July, private patients who are already receiving treatment - or about to start treatment - with a newly funded medicine will not have to shift to the public system for 12 months. Associate Health Minister David Seymour, who has championed the rule change, said it would lessen stress on private patients by enabling continuity of care, and pressure on the public system which would no longer have to deal with a sudden influx of patients. However, the move has been criticised by opposition politicians as "a subsidy for private insurers", which already cover the cost of medicines newly funded by Pharmac, and of little benefit to patients. The Association of Salaried Medical Specialists, which represents 6500 senior hospital doctors and dentists, said its members working in oncology and haematology had "significant concerns" the change would widen inequities for patients. In a letter on June 13 to Pharmac's acting chief executive Brendan Boyle, the union's director of policy and research, Harriet Wild, quoted a briefing to the minister saying the policy change "would not increase volumes of cancer medicines provided in New Zealand, as only the location of treatments will change". "It will simply shift some of the existing capacity to the private system, where patients will need to fund infusion costs out-of-pocket," Wild wrote. "There will be pressure on the public system to ensure a smooth transition in treatment regime, which may mean delaying treatment for other people already waiting on the public list and unable to self-fund to start in private. "This potentially creates a two-tier waiting list and a system where those with more financial resources, will be prioritised for treatment." Furthermore, the shift of resources and inevitable increase in demand was likely to speed up the exodus of staff to the private sector, making public waiting lists even longer. A "back-pocket Q&A" provided to Seymour ahead of a Cabinet meeting on April 7 noted that the current eligibility criteria in the Pharmaceutical Schedule (excluding patients in private settings) was "designed to ensure public funding for medicines was prioritised for those managed in the public health system for cancer treatment, assessed by need, rather than public funding supporting those who chose to access treatment in private facilities. "Often the private treatment is funded from private health insurance that people have paid premiums into." In the same document, the minister said there was no plan to expand the policy to include other types of medicines or treatments "at this stage". "With that said, I've asked the Ministry [of Health] to do further work in this area to explore the possibility of broadening access to all publicly-funded medicines in private facilities - not just newly funded cancer medicines. "I encourage the private health providers and insurance companies to work closely with the ministry to support their understanding of how this might work in practice." Wild said opening access to publicly-funded drugs even wider would pull more staff away from the public system, reducing access for the majority who relied on it. "That would establish a system where a patient's ability to receive timely cancer care would depend on whether they could afford the out-of-pocket infusion costs." The government's 2024 Budget boost to Pharmac to widen access to medicines for patients had not been accompanied by extra resources for Te Whatu Ora to deliver the treatments, when public oncology services were already swamped with demand, Wild said. "Our members are increasingly needing to manage deteriorating patients, who are unable to access chemotherapy infusions in clinically acceptable timeframes. "This is unacceptable and represents a significant failure to invest in a planned and co-ordinated way to enable the public system to meet the needs of cancer patients, including those eligible for newly funded cancer medicines. "Whenever a new cancer drug is funded, it must be accompanied by an increase in the full package of care (staffing, infusion space, pharmacy) so that patients can actually receive the medicines within clinically acceptable timeframes." The Health Minister and David Seymour's office have been approached for comment. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
