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Nurses have accused Auckland DHB of playing "Russian roulette" with patient safety by allowing up to 600 daily hospital visitors during the Delta outbreak.
The claims include reports of one patient having sex in a shared room.
The allegations come as WorkSafe issued an improvement notice, forcing the Auckland DHB to engage with its health and safety representatives.
The Herald can reveal a letter was sent to director general of health Dr Ashley Bloomfield last Wednesday from a New Zealand Nurses Organisation (NZNO) delegate, flagging a number of alarming visitor policy breaches at the DHB, including people turning up in groups and refusing to wear masks.
In an email seen by the Herald, the Ministry of Health's clinical adviser of performance Stuart Powell responded on behalf of Bloomfield, saying it had checked with the DHB and was satisfied it was working "within the national guidance".
It comes after the Herald last week revealed inconsistencies between hospitals' visiting rules under alert level 4.
While other hospitals were only letting visitors in on compassionate grounds, Auckland DHB's policy allowed each patient two visitors, one at a time.
Unions say not only was Auckland DHB's policy "unsafe and unacceptable" but it was being breached every single day as it was not being enforced by management.
Auckland District Health Board safe staffing co-ordinator and lead NZNO health and safety rep Ben Basevi said the problem had become so bad he'd been forced to put his job on the line to get management to listen.
"A lot of staff, including charge nurses, have raised these issues with management over the past three weeks and they have all been shut down."
After a complaint from the NZNO, WorkSafe issued the DHB an improvement notice, forcing it to engage with its health and safety representatives.
The DHB's own health and safety representatives also issued a separate provisional improvement notice giving management until next Monday to comply, otherwise WorkSafe could intervene and potentially investigate.
Basevi said a DHB director met yesterday morning with a number of staff who reported visitors not wearing masks, wandering around different wards, intimidating staff, mingling with other staff and patients and one visitor having sex with a patient.
"One Covid patient even threatened to discharge themself unless their visitor could stay."
Basevi said there wasn't enough monitoring of visitors and security guards were allowing groups of visitors through.
"It's totally unsafe and unacceptable."
The DHB director said the concerns were valid and he would raise it with higher management and look at tweaking the policy, Basevi said.
"I've told them there's no time for a review, they need to act urgently. They need to lock the hospital down, close its doors to all visitors and have security only get visitors in under compassionate grounds."
NZNO organiser Craig Muir said there were two problems - the policy was "rubbish" and enforcement was not happening.
"The visitor policy is nearly impossible to enforce with lax physical distancing, visitors who don't wear masks properly or when they should, and regularly seeing bubbles mix.
"They are playing Russian roulette with patient and staff safety."
Muir said the union was receiving "lots and lots" of complaints from staff and hearing similar concerns from patients.
"Members are extremely concerned ... we could have a real crisis on our hands."
Doctors union Association of Salaried Medical Specialists (ASMS) executive director Sarah Dalton said the DHB's visitor policy had really been getting up people's noses because they didn't think it was safe for patients or staff but were getting pushback from management.
"The view of the unions is that there was no proper consultation prior to making the decision to allow two visitors per patient."
Auckland DHB director of provider services Dr Mike Shepherd said the DHB was making changes to its visitor policy following feedback from staff and union representatives.
"The safety of our staff, patients and visitors is a priority for us and this is a decision that we have made with much consideration, including a full risk assessment," he said.
The changes come despite Shepherd insisting: "Our current approach is aligned with national guidance on hospital visitors."
A Ministry of Health spokesperson said in a statement last night: "We understand Auckland is working within the national guidance. We are also aware that Auckland DHB is connecting with the NZNO regarding their local approach, and we are supportive of that engagement."
Meanwhile, 29 staff at Middlemore Hospital have been stood down after a male patient tested positive for the virus.
Staff screened the man for Covid before he was admitted but it was not known that he had been at a location of interest until the next day.
When the man came down with a fever, a Covid swab was taken.
But hospital staff made the call to "leave him where he was", Health Minister Andrew Little told media.
The man subsequently tested positive, leading to 29 staff at Middlemore Hospital now being considered close contacts for 14 days.
Eleven were doctors, 13 were registered nurses, two were healthcare assistants and the others were a phlebotomist, cleaner and ward clerk.