Patient waiting lists and health targets are not the only concerns at Waikato Hospital where failing equipment and under-resourcing are adding to pressure on doctors and nurses, according to a leaked email.
Operating theatre lights are so dim doctors can't see properly during surgery and the air-conditioning is too warm, meaning patients are at increased risk of infection, according to the allegations.
The claims include that the DHB is chronically understaffed due to recruitment issues and cost-cutting, but its reputation for over-burdened staff meant desperately needed specialists were put off applying for positions.
Two "corridor beds" have been introduced in each ward across Waikato Hospital so more patients can be squeezed into wards from the Emergency Department where another health target states that 95 per cent of patients must be admitted, discharged or transferred from the ED within six hours.
The new policy is putting extra pressure on exhausted nursing staff according to an insider, but the DHB remains the second worst performing in the country when it comes to shorter stays in the ED according to national health target results released on Tuesday.
The insider, who requested anonymity, told the Herald a $14 million virtual health system that doctors fear will add more time to their hectic schedules won't reach a core target market - patients in rural areas - because they don't have access to the technology needed to use the service, such as a computer or smart phone.
Lastly, a change in cleaning processes meant senior clinicians, many of whom earn annual salaries of $200,000-plus, must now make time in their day to empty their own office rubbish bins.
The concerns came to light as part an investigation by the Herald which revealed a letter from 13 orthopaedic surgeons lambasting senior managers over a directive to stop follow-up checks with patients.
Waikato DHB executive director of services Brett Paradine said new theatre lights had been approved and improvements to air-conditioning in the operating theatres would take place over Christmas.
He said two specialists had been recruited to start in February and April to cover shortages in the orthopaedic department.
A locum would also be recruited to help with cover while three new theatre nurses had also been appointed and there was approval for nine more.
Paradine admitted there was a new policy to install up to two "overflow beds" in each ward to cater for patients coming through the Emergency Department.
The Herald understands this is to help the ED avoid breaching the six-hour target, where a patient must be treated, discharged or transferred from the ED within that timeframe.
Paradine said the beds, which all have curtains and call-bells, would not be stationed in corridors or staff rooms but in family and treatment rooms.
The virtual health system, dubbed SmartHealth, already had 3000 patients and 800 clinicians signed up to it according to DHB executive director of virtual care and innovation Darrin Hackett.
He said Spark was working through data issues in remote areas such as Taumarunui where there were gaps in the service.
Hackett would not confirm the cost of the system but said a modernisation of technology at Waikato Hospital to support the service, such as new iPhones, iPads and webcams, had cost several million dollars.
A new recycling policy was the reason behind a change in rubbish collection, according to DHB spokeswoman Lydia Aydon.
All administrative areas at Waikato Hospital now have centralised waste bins to reduce the time and resources spent on maintaining and collecting individual bins and to encourage staff to separate waste and recyclable paper, Aydon said.
"So it means that smaller individual rubbish bins aren't emptied by the cleaners. For instance, I have a small bin in my office and at the end of the day I just pop into the kitchen and dispose of my rubbish - we all do it, including the CEO."
Labour MP Sue Moroney called the new process "penny-pinching" and said she understood a proposal to widen the policy to all wards was currently being consulted.
"These duties will fall to nurses and that's going to impact on patient care because they're already under pressure."