She said while the aim was to see patients in a reasonable timeframe, busyness and capacity constraints meant people assessed as less urgent following triage may wait longer than expected to see a doctor.
“While people still receive support and treatment – such as pain relief and x-rays – while waiting to see a doctor, we recognise that long wait times can be frustrating, and we sympathise with anyone who may experience distress while they are waiting,” Fraser-Chapple said.
“We encourage the community to explore alternative options for health service, when possible, to enable EDs to be used for urgent treatment only, which will help with any capacity issues. Healthline, [visiting your] local pharmacy and calling your general practice for advice are all options available to non-urgent issues.
“A high number of patients in acuity is becoming commonplace across all hospitals. We are very busy and we regularly operate at a high level of occupancy. We’re seeing people that are sicker, and it does place pressure on staff and resources.”
Fraser-Chapple said the hospital’s capacity was being looked at.
“We have a national infrastructure team looking at hospital development and capacity requirement. As far as creating infrastructure, that is a longer-term issue, and more Government policy than local direction.
“Pressures exist in primary care and in secondary care in our hospitals, and it’s a very complex situation that doesn’t have a single fix. We’ve got a lot of people trying to understand how that situation can be remedied. It’s about what the system needs to create equitable and fair care for New Zealanders.”
A long-standing health advocate at Te Whatu Ora Whanganui, who did not want to be named, said it was no surprise that EDs, as well as mental healthcare, were ongoing hotspots.
“We all know the health system is under the pump. We’re in an environment where a perfect storm of factors are leading to what can only be described as less-than-desirable outcomes for consumers.
“We have under-staffed and under-resourced workforces and all the complexities that come out of that for consumers experiencing services. It will continue to be an issue if nothing changes, and the same challenges exist for mental health services.
“We are hamstrung by the previous population-based funding. That is undergoing change through health reforms, but there are challenges now around how localities can do things under a reform environment.”
Emma Rawson-Te Patu, president-elect of the World Federation of Public Health Associations, said one of the problems was not having enough GPs in the district.
“Even if people want to be enrolled, there is a lack of GP practice capacity. So you’ve got this part of the population who will not go to a GP for treatment when worsening health is avoidable, but turn up to EDs when they’re in crisis or because it’s free.
“To alleviate stretched capacity, we need to address workforce issues as well as occupancy, management and design issues. Beds in hospitals are only available if there are enough staff. How do we look after staff and improve the environment so staff aren’t leaving because they’re burned out?
Rawson-Te Patu said it was not sustainable.
“If we shifted to a mindset of preventive healthcare and put more resource in that area, we could effect dramatic change. But that is quite a huge shift for the Government. I’m not seeing the resourcing that is needed to make preventive strategies the primary focus of the healthcare system.
“What we currently have still is a healthcare system driven by primary and hospital care – solving the issues as they arrive, as opposed to preventing the health issues from arriving. Our public health transformation needs to go two or three degrees further. It’s about being brave enough to do what’s required.”
Whanganui Mayor Andrew Tripe said there were multiple factors contributing to the situation of beds in ED corridors, such as winter flu, Covid-19, a backlog of delayed treatment and overdue surgery, staffing issues, GP practices not enrolling new patients, and an older, ageing, sicker and increasing population.
“The transition to a centralised model of delivering health is still in relatively early stages – it’s not an overnight job,” Tripe said.
Tripe said the council had a focus on the ‘four wellbeings’ and needed to make sure the community was being served, whether it be in education, housing or health.
“We’re constantly talking with central government about that. I’ve had multiple meetings with MPs, and we’re talking to the National Party as well. This is not a fix overnight – we’ve got a nationwide problem.
“In our community, we need to address primary healthcare.
“If we can prevent people from needing the hospital because we’re treating them at home or in GP clinics – or [they’re] proactively focusing on living a better life – we’ll reduce the burden on our emergency department.
“Just doing the basics – exercising, drinking water, not Coke, walking up the stairs rather than taking the lift, getting fresh air. It’s about focusing on how we create a society that is physically, emotionally and mentally well, as opposed to fixing sickness.”
Tripe said if Whanganui had a growing population, it would need increased capacity in the emergency department.
“There are no plans to address that, but [the] burden will continue to fall there.
“Is a centralised health system better for our local population? I think we need a model that includes localism: the concept of centrally funded, regionally co-ordinated and locally led. We know our communities better – trust us on the ground.
“We can work with our community to look at wellbeing but, for the council, the work ultimately is to take a strategic response to partnering with central government to deliver services that help our people live the best lives they can.”
The co-chairs of Te Whatu Ora Whanganui consumer governance oversight group Te Pūkāea, set up to provide advice from “a patient and whānau view”, did not respond to requests for interviews or comment.
Public Interest Journalism funded through NZ On Air.
