A failure by bosses at Waikato Hospital to cut emergency department waiting times, jeopardising millions of dollars of Government funding, has been blamed on a lack of staff cohesion.
Waikato District Health Board chief executive Craig Climo, cited "the way we do things" as part of the problem at the Hamilton hospital.
The board has until the end of June to meet the Ministry of Health target, which dictates that 95 per cent of patients be admitted, discharged, or transferred from emergency within six hours. It has been ranked second-last out of 20 health boards nationwide in meeting the target, slipping from 89 per cent to 84 for the first quarter of the current year.
Mr Climo's comments follow a campaign this month at Waikato Hospital urging staff to help achieve the target.
He said there was no "joined-up-ness" at the hospital.
"What is the role of the rest of the hospital in respect of the emergency department? Is it set up and resourced in a way where it's expected to be fully self-contained ... or is the role of the staff in the rest of the hospital to put shoulder to the wheel where it's required?"
Resident Doctors Association representative Dr Curtis Walker said Waikato Hospital's frontline staff already had "their shoulders to the wheel and work their guts out every day".
"Of course we support increasing efficiency and eliminating waste, however the troubles in ED are reflective of already overstretched staff trying to meet the needs of patients already in the hospital, as well as those needing clinic appointments and elective care.
"It is simply impossible, for example, for doctors to run outpatient clinics, do ward rounds and simultaneously see patients acutely in the emergency department ..."
Association of Salaried Medical Specialists executive director Ian Powell agreed the target should not be the sole responsibility of the emergency department and said Waikato Hospital did not have enough doctors.
"In the emergency department they've had vacant positions they've been trying to recruit to and not succeeded. The situation around the country is that we are short-staffed and doctors and specialists are working longer hours to keep the system going."