Emergency department wait times show health system under 'extreme stress' - Todd Muller

One in five people are waiting more than six hours to be seen at Tauranga and Whakatāne Hospital emergency departments (EDs).

Ministry of Health data shows 78 per cent of patients that presented to a Bay of Plenty District Health Board emergency department between January and March this year were seen within six hours.

This is down from 84.4 per cent for the same quarter in 2021 and 86.7 per cent in 2020. From July to September 2021 81.5 per cent of patients were seen within six hours and from October to December the figure was 79.7 per cent.

The ministry's target is 95 per cent of patients will be admitted, discharged or transferred from an emergency department within six hours.

Bay of Plenty MP Todd Muller told Local Democracy Reporting the data "talks to a health system that's under extreme stress".

"When we talk health system, what we are meaning of course is doctors and nurses and health workers," Muller said.

Bay of Plenty MP Todd Muller. Photo / Andrew Warner

"The people in our community who are in the hospitals [are] trying to do the best they can, but under really, really difficult circumstances."

Muller said the target to be seen within six hours was one "we're missing by miles, with one in five locals having to wait significantly longer than that ... and for a lot of people sitting in a waiting room [or] emergency department for six hours is a hell of a long time."

"When ED waiting times are unbearable, people simply leave - sometimes with tragic consequences."

Muller said he has heard from people accessing healthcare as well as healthcare workers that the stress on the system is impacting the quality of care given.

"The stories I'm hearing from individuals who are going through the hospital, they have so much respect for the nurses, doctors and the health workers, but the nurses appear just broken with the weight of what they have to do.

"They've been in this sort of crisis mode for a couple of years now, if not longer. We saw this coming, this is the frustrating part," said Muller.

Te Whatu Ora - Health New Zealand Bay of Plenty chief medical officer Dr Kate Grimwade said Omicron, new Covid-19 sub-variants, influenza and other respiratory illnesses are impacting the levels of demand the hospitals are currently facing and the levels of sickness within staff.

"Both emergency departments have been busy for many months. This has fluctuated with the Covid situation but there has been a steady increase in ED use year on year," Dr Grimwade said.

"The current pressure is due to a combination of factors, which include increasing patient numbers presenting in general and challenges such as managing different requirements for patients around Covid risk.

"People presenting at ED are seen on the basis of clinical need, with the most seriously ill seen first.

"If you do need emergency care however you should know that the ED services are there for you, and attend," she said.

Grimwade said all ages are experiencing more significant respiratory illnesses this season because of the measures taken to mitigate Covid risk in the past two years.

"In addition, having prepared themselves for Covid infection, people have a higher level of anxiety around respiratory illness and may be seeking care differently to pre-Covid flu seasons."

Muller was critical of the recent health reforms that saw the country's 20 district health boards disestablished and management of the health system handed to Te Whatu Ora - Health New Zealand.

"We did have a period of time where we got through the first wave of Covid and we were promised that more resources would go into the health system to ready it for the next wave and the flu wave and it just simply hasn't happened.

"All that's happened is a huge amount of money and focus on restructuring governance and putting hundreds of more people down in Wellington," Muller said.

"There's not enough people on the front line. We're 4000 nurses short ... The Minister of Health urgently needs to refocus the $486 million being spent on health reforms towards relieving pressure in EDs."

The Ministry of Health was asked to respond to Muller's call to redirect the money to emergency departments.

Tauranga Hospital. Photo / George Novak

A Health New Zealand spokesperson did not respond directly to the question but said the organisation was closely monitoring the pressures across the healthcare system.

"We know services are finding this winter challenging and we are working with regions and districts to implement a range of initiatives," the spokesperson said.

These included hospitals co-ordinating planning to ensure resources were deployed and shared to support access to care where it is needed, making it easier for GPs, ambulance services and Healthline to make direct referrals to radiology.

The initiatives included expanding telehealth to alleviate pressures on EDs and extending opening hours for urgent care into evenings and weekends, where there was capacity to do so, so more people could access the care they needed.

The spokesperson said during the past two weeks, there had been a "significant increase" in Covid-19 cases, on top of other respiratory illnesses, resulting in a larger proportion of the population and health workforce unwell.

"While this isn't unexpected in winter, we are seeing its impact earlier than usual with more cases presenting to our emergency departments, general practices, and medical centres.

"Over the past two months, for instance, some EDs have been experiencing higher presentation volumes, between 21,000 and 23,000 presentations per week - however, this rate of ED presentations nationally is still in line with rates seen in recent years."

Local Democracy Reporting asked Health New Zealand Bay of Plenty for the average wait times at the Tauranga and Whakatāne Hospitals for the last quarter and the last two years, but this was referred to as an Official Information Request that can take up to 20 working days.

Public Interest Journalism funded through NZ On Air.