Healthcare workers were stranded overseas because inexperienced officials deciding who deserved MIQ rooms "strictly followed the criteria rather than considering the wider contextual factors", government documents reveal.
Another problem was a "breakdown in process" that meant some DHBs didn't actually forward on applications for rooms to the Ministry of Business, Innovation and Employment.
The Herald on Sunday has obtained emails and documents that show why some doctors, surgeons and midwives weren't able to get into New Zealand, despite critical healthcare workers being able to apply for an emergency allocation of rooms.
Health Minister Andrew Little asked his officials to get to the bottom of the situation, after his office received numerous and troubling examples of workers being locked out of the country.
That included Dr Jim Faherty, who couldn't return to his job as clinical director of Southland Hospital's obstetrics and gynaecology service, after travelling to the United States to care for his dying father.
In September, Southern DHB chief executive Chris Fleming wrote a letter in support of Faherty, who is the only person at the DHB who does certain surgeries, and had a list of more than 30 operations awaiting his return, "some with potential cancer or pre-cancer diagnosis".
Faherty's service had vacancies and more than 200 patients were waiting too long for treatment, Fleming wrote: "His absence is exacerbating this situation and denying the Southland population health care."
Later that month the Herald revealed the MIQ issues for healthcare workers in a front-page article, in which the Intensive Care Society warned ICU nurses - who are in short supply globally, including in NZ - couldn't get into the country despite accepting job offers.
That report was followed by an October 6 email to Little from Dr Stephen McBride, Middlemore Hospital's acting clinical director of infection services, asking for MIQ rooms to be prioritised for healthcare workers, given "the sector is short-staffed across every area, and staff are pulled in multiple directions with vaccination/MIQ".
The next day, Little's office contacted a senior health official asking if all critical healthcare workers had access to the emergency allocation of MIQ spots.
"Yes they do," the ministry official wrote back. "We worked with MBIE on this when the policy was developed."
However, after more investigation Little's team concluded that wasn't the case. His private secretary summarised the situation in an October 11 email. One problem, she wrote, was that some DHBs hadn't forwarded requests for MIQ rooms to MBIE, as they were meant to do after the applications were first endorsed by the Ministry of Health.
And even when the paperwork was sent, it could be incorrectly assessed by inexperienced MBIE staff.
"Of note is that owing to staff changes in the MBIE team who grant these allocations, some applications for returning healthcare workers may have been declined (multiple times) by new staff strictly following the criteria, rather than considering the wider contextual factors," Little's private secretary wrote.
Other examples of healthcare workers being kept out include a New Zealand midwife in Western Australia, who had been trying unsuccessfully to return home since July to take up a job. MBIE rejected her application for an MIQ room, saying it wasn't satisfied her return was time-critical for the purpose of delivering a public health service.
"I cannot believe this response bearing in mind the current crisis in lack of midwives and in particular the shortage in [redacted] causing regular closures of the birthing unit," the midwife wrote in emails to the College of Midwives in October, which was sent on to the Health Minister.
"MBIE are very hard to deal with and change their mind with the wind. Initially they declined me as they said I could only return to a new role and they thought I was returning to an existing one. When I reapplied highlighting my new job with [my] acceptance letter I got the same response.
"Luckily I 'won' a place in the MIQ lottery so will be able to start work in November."
On October 20 Little announced 300 MIQ spots would be guaranteed every month for the health and disability sector, with the first rooms allocated late last month.
"We have already brought in thousands of health workers, but lately employers have been telling me that it's getting harder to secure places, so we're sorting that out," the Health Minister said of why the change was needed.
Earlier that month Faherty was granted an emergency spot in MIQ on his third application, after media coverage of his situation and local National MPs urging action.
The overall MIQ bottleneck was set to ease from January 17 next year when fully vaccinated New Zealanders and other eligible travellers will be allowed to return from Australia and self-isolate instead of entering MIQ. That will be widened to include some other countries from February 14, and to encompass visa holders from April 30.
However, some health experts are calling for those plans to be postponed because of the emergence of the Omicron variant.