Visitors driving to Auckland City Hospital can face lengthy queues to get onto the grounds and to carpark buildings that are often near capacity. Nicholas Jones reports on how the DHB is trying to ease pressure - including by asking university students to stay away.
One of the country's largest hospitals is short of 100 carparks - leaving patients and visitors in lengthy queues or circling surrounding streets.
It can take longer than 30 minutes to get into the grounds of Auckland City Hospital and to a carpark building, and university students have been asked to not take up spots meant for visitors.
Staff are being encouraged to take the bus or train, and moving outpatient clinics off-site has been mooted, along with re-routing bus links to the eastern suburbs.
However, there's no easy fix, as intensification and a growing and ageing population piles more pressure on the central city site. The situation shows why the region's DHBs want at least one new hospital built in Auckland.
Parking was discussed at a recent ADHB board meeting. There have been talks with the University of Auckland about students from the nearby medical school parking in Carpark A, minutes state , with "all measures available taken to improve the situation".
Hospital staff are being encouraged to take the bus, "however, at times during the day the hospital was still short of 100 car parks".
Board member Dr Lee Mathias suggested approaching Auckland Transport about rerouting the Tāmaki Link bus past the hospital. Moving outpatient clinics to the Greenlane site was raised, however that site has its own parking problems.
There are 713 public parking spots at the Grafton site, including some for certain types of patients such as outside the cancer and blood building. Other spaces are for staff including those on-call.
An Auckland DHB spokeswoman said parking was "a long-standing challenge" shared with other central Auckland organisations. The university had been very helpful encouraging students to take transport or park elsewhere.
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"There is no easy solution. But, as our board minutes show, our board and leadership team are aware of, and concerned about, the impact on both patients and staff."
ADHB encourages patients, whānau and staff to use public transport or get dropped off when possible, with bus stops outside the hospital and Greenlane Clinical Centre. More staff are cycling to work, and in the long-term the DHB is working on other transport options and moving some services away from hospital.
Andrew Skelly, organiser for the Public Service Association (PSA), which represents many health workers, goes to the Grafton site most work days.
"Sometimes you have to wait half an hour or more just to get into the carpark."
He sympathised with the DHB over what is a long-running issue.
"They've done as much as they possibly can...they've put on shuttle services in-between hospitals, they have tried to get parking off-site for staff, they created different systems to ensure shift workers could get parking.
"They've never tried to force people but they did try encourage everyone who lived in a closer vicinity to use public transport."
Skelly understood the DHB had asked Auckland Transport about subsidised travel for staff, and said another problem could be planning regulations preventing more carparks being built, because of concerns over traffic.
"ADHB have a lot of plans to expand the Greenlane site...but it's just going to keep growing. Auckland - it doesn't matter if you live north, south, east or west, there's a big subdivision happening in everyone's neighbourhood."
While carparks were scarce, Skelly said a related issue was the cost of parking.
"You see quite a number of elderly people looking at their parking ticket in amazement at how much they have to pay."
Parking at Auckland City Hospital costs $5 for an hour, with rates climbing up to $19 for more than seven hours.
Waitematā DHB last year made changes including a $50 discounted ticket for one week of parking, for family members and at the request of a ward charge nurse. That followed concerns including from Grey Power that costs would stop people visiting loved ones.
The four DHBs that make up the northern region – Northland, Waitematā, Auckland and Counties Manukau – made a case for a new hospital, possibly two, in their recent Northern Region Long Term Investment Plan.
Over the next 20 years nearly 60 per cent of New Zealand's population growth will be in Auckland and Northland, the report found, with medium growth forecasts predicting another 562,000 people in the region.
The number of people aged over 75 is expected to more than double in that time, and the northern DHBs predict another 2055 beds and 41 theatres will be required.
In an appearance before Parliament's health committee last year , former chairman of the three Auckland region DHBs, Lester Levy, warned demand for services was outstripping population growth: "the story of Auckland is a story about growth. Last year Auckland grew by the population of Nelson".
This week's Budget included $1.7 billion over two years of capital funding for health, much of which will go towards a new hospital in Dunedin. A centrepiece Budget 2019 initiative is to put trained mental health workers in GP clinics - treating people in the community and away from busy hospitals.