A major independent report has found nurses are overworked and exhausted because of consistent understaffing and that patients are not always getting full care.
The report is looking into a safe staffing programme that was put in place 15 years ago but not every district health board has been following properly.
It has found hospitals are regularly short of nurses and that has been made worse because of border closures.
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The report said the extra pressures from Covid-19 had taken a significant and lasting toll on the wellbeing of nurses and their whānau.
If the number of nurses is not increased, it would be impossible to achieve safe staffing levels, the report said.
The full report is available online here.
Health Minister Andrew Little said the report showed why the health system must be overhauled.
"I ordered this review back in August because of the long-standing concerns of the Nurses' Organisation and the Public Service Association about a lack of follow-through by District Health Boards on the safe-staffing accord for public hospitals. The review report, which I'm releasing today, confirms those concerns," Little said.
He said the government was making some progress, employing an extra 3621 nurses in DHBs, increasing nurses' wages, and making it easier for foreign-trained nurses to settle in New Zealand.