Staff shortages at Rotorua Hospital are reaching critical levels, claim the junior doctors' union. File photo. Photo: RNZ / Karen Brown
Staff shortages at Rotorua Hospital are so dire that patients are being sent back to the emergency department from other wards, according to the junior doctors' union.
Health New Zealand has now promised to consult with staff over its controversial plan for ED specialists from Rotorua to cover Taupō ED, which is short five doctors - but staff remain sceptical that management can find a solution.
One senior Rotorua doctor said even before being asked to fill the holes in Taupō's rosters, the ED team was already dangerously understaffed.
The clinician - who RNZ has agreed not to name - said it was a blow when hospital bosses declined their request earlier this year to recruit another two senior doctors.
"This was a small ask - it was not bringing us up to staffing levels at comparable sized EDs, or anywhere near the recommended staffing levels as cited by the Australasian College for Emergency Medicine 'minimum safe medical staffing for EDs'.
"To have that business case declined was disappointing to say the least.
"Then the bombshell yesterday that we are now expected to spread our already stretched workforce to cover Taupō ED. "
Staff were not reassured by Health New Zealand's promise to consult with them, as they had "lost trust" in management, the doctor said.
RNZ understands Rotorua ED has just 12 senior doctors - most of them part-time - while similar sized EDs with comparable patient numbers have between 18 and 21 consultants.
Resident Doctors Association head Deborah Powell said staff shortages were even worse in the medical wards.
"They look after people who've had heart attacks, people in heart failure, people who have had strokes.
"Because we were short, the ED doctors got told they had to admit the medical patients.
"So over and above their ED work, they had to do the work of the medical registrars as well."
Taking senior doctors from Rotorua to staff Taupō ED would mean less supervision and back-up for trainee consultants, she said.
"And then there's the workload, that's not only arriving at the ED but also being referred to the ED from inside the hospital, that's usually done by other doctors who are now absent.
"So the doctors are Rotorua are getting hammered from every direction. And they're absolutely right to say 'We can't do Taupō as well'."
Rotorua Hospital nurse Lyn Logan - the ED delegate for the Nurses Organisation - said she could understand management's rationale (to keep Taupō open) but it was "robbing Peter to pay Paul".
"The two EDs in Rotorua and Taupō already work closely together, but we both need doctors.
"If we're not resourced properly, we're not going to meet the government's new six-hour target [for ED wait times].
"And that's what really worries me.
"We all want to give the best care we can to patients coming through the door and making sure they're safe and not in pain and not waiting huge times. And it really frustrates us that we can't do that."
Taupō mayor David Trewavas said he was reassured by Te Whatu Ora management there would be no loss of service at the ED.
"They're five doctors short and they're desperately trying to fill them. Some of the doctors might have to travel to fill in in the meantime.
"Their internal issues are not really to do with me of course, I'm just trying to advocate for the community that we need this service desperately."
Health Minister Shane Reti said emergency departments nation-wide were suffering critical workforce shortages and he expected front-line hiring to continue.
"As the commissioner [Dr Lester Levy, who has replaced Te Whatu Ora's board] has said, there is overspending, not underfunding."
However, in a message to staff on Wednesday, Te Whatu Ora chief executive Margie Apa confirmed recruitment for clinical roles was on hold.
It was "vital" that the agency carefully manage its current overspend, she wrote.
"This overspend is a consequence of recruiting clinical staff ahead of budget and having operating models that are not affordable.
"Once budgets are confirmed, leaders will look at how they manage their teams and work within those budgets.
"Recruitment will then be able to proceed as long as roles are within budget or are replacing existing roles."
