A senior doctor working at Christchurch Hospital says he’s concerned about its ability to cope as patients are treated in corridors lined with beds, stretchers and wheelchairs.
Senior doctor Dominic Fleischer has worked through Christchurch’s earthquakes and mosque attacks, but he believes the hospital would struggle now, as it continues to operate above 100% capacity this year.
“I’m not convinced now if something happened we’d be as effective,” Fleischer said.
“The staff are outstanding, the hospital is excellent, but still, we’re far more compromised now.”
Fleischer said the hospital had hit a “point of crisis”.
“It’s above 100% of its capacity, literally every bed is taken and then some,” Fleischer said.
“EDs are generally always busy but this last year has been especially so.
“Things can very quickly fall over. Rather than a gentle decline, you just have a catastrophic failure of the system.”
Fleischer said because of hospital beds being at full capacity, patients coming through the emergency department couldn’t be admitted to ward beds.
“The ED just backs up and gets busier and busier.
“That’s been the biggest hindrance for us – moving patients through the department [and] our inability to see patients in a nice, timely manner – forcing us to see patients and treat them in corridors.
“For years, we knew this was coming. If you look at graphs of predictions of patient numbers coming to the ED years ago, we’re now hitting exactly what those predictions said they would be.”
Health New Zealand Canterbury group director of operations Hamish Brown said the hospital had been in and out of critical overload, also known as code red, for the past three to four weeks because of “very high presentation rates”.
“In this situation, we use all available spaces to safely care for patients,” Brown said.
“This includes utilising spaces such as resuscitation bays or our consultation rooms to perform clinical assessments to maintain privacy.
“Providing care to the local community remains our priority, and we never turn anyone away from emergency departments in any hospital across New Zealand when they need our care.”
Brown said initiatives have been put in place to manage the high demand, including fast-tracking pathways for faster admissions and offering other ways to get care for people with less-urgent problems.
He said a mass casualty event is a separate situation and is managed through a different process.
“We have systems in place should a mass casualty event occur,” Brown said.
Thousands of senior doctors are on strike until midnight tonight, after walking off the job yesterday.
Their long-running pay dispute with Health New Zealand continues, with doctors saying the latest offer represents a “real pay cut” when recruitment and retention are critical.
Association of Salaried Medical Specialists (ASMS) executive director Sarah Dalton told The Front Page that Health NZ spends upwards of $200 million annually on locums, rather than investing in salaried specialists.
“Why would you prioritise letting locum rates go up and up for temporary labour? [They] do a good job, but they don’t do the whole job and they’re not here for the long haul, while at the same time you’re saying to a salaried doctor, no, we’re not going to pay you a retention allowance for working in Gisborne or Invercargill.
“It would actually be cheaper for Health New Zealand and better for the public if they incentivise salaried work and disincentivise locum work,” she said.
Dalton said negotiations to date have been “empty” and the only time an offer was brought to the table was when they called strike action.
“Now that’s pretty blunt and pretty basic. We would’ve liked to have had senior enough people across the table right from the start to work through issues with us.
“Can we talk about staffing levels? Can we talk about where your workforce planning is at? Can we discuss how our collective agreement and negotiations fit into the short and medium-term plans?
“We don’t get that. We get, you can have this much, but no more. And also, if we give you this much, don’t tell the others, because they’ll want it too. It’s real kindergarten stuff,” she said.
Health Minister Simeon Brown claimed ASMS was putting pay and politics ahead of patients, after thousands of elective procedures and appointments were postponed because of the strike.
He said it was “deeply concerning” the union had chosen to strike at the height of the busiest period.
“Every winter is busy for our emergency departments, and this year is no exception,” Brown said.
“This action will delay care for an estimated 13,000 patients, many of whom may now be forced to seek treatment in emergency departments.”
Brown said he’s made it clear to Health New Zealand improving emergency department performance is one of his top priorities.
“The Canterbury district stands out as one of the best performers, with 81.5% of patients admitted, discharged, or transferred within six hours during that [most recent] quarter.
“The Government is delivering record health investment to improve outcomes for patients.
“Selfish strike action by some of the country’s highest-paid public servants does nothing to solve the challenges in our health system; it only makes things worse for patients.”
Labour associate health spokesman Peeni Henare said “everyone should be able to get the care they need when they need it”.
“Sadly, that doesn’t seem to be the case for some patients at Christchurch Hospital and it’s not good enough for them or their families,” Henare said.
“National has been patting itself on the back this week, re-announcing the bare minimum of funding to keep our hospitals going.
“Meanwhile, we don’t have enough doctors in New Zealand.
“We lose too many to Australia and can’t recruit the doctors we need from overseas.
“People are getting sicker because they can’t afford to see their GP when they need to.”