Nurses at Dargaville Hospital are concerned the public isn't being told there is no doctor on duty most nights. Photo: RNZ / Peter de Graaf
A leaked email shows staff at Dargaville Hospital were so concerned about the risk of not having a doctor on duty overnight they wanted the hospital's 12-bed ward closed down.
While nurses and local managers now agree with keeping the hospital open - after weighing up all the risks and options - they said the decision to keep it functioning was "100 percent political", and not based on clinical safety.
The email stated staff and managers were working together to provide the best care possible under the circumstances.
The nurses continued to be concerned, however, that the public was not being told there was no doctor physically present between 5pm and 8am.
During those hours, medical advice was instead mostly provided by telehealth, a commercial service in which a doctor at another location offers advice via a video call.
"Te Whatu Ora [Health NZ] does not plan to advise the public that they should expect anything other than normal hospital service, which is a real concern … The public need to be aware that the service provided at the Dargaville general ward overnight is predominantly provided by telehealth," the email stated.
The leak also revealed Dargaville Hospital nurses had asked Health NZ to provide an undertaking in writing that the organisation would keep trying to recruit medical staff, and that they would be in place as soon as possible.
The email stated that, despite a rocky start, local staff and managers were now working together closely to provide the best service they could, despite the decisions being imposed on Dargaville Hospital from a national level.
Health NZ northern deputy chief executive Mark Shepherd said Dargaville Hospital was safe, and any patients would be well looked after.
"All patients admitted to Dargaville Hospital are assessed as appropriate for the care currently available at the hospital, with ambulance services transporting all high-risk patients directly to Whangārei Hospital," he said.
The hospital currently had a doctor on-site until about 6pm daily, with a senior medical officer (SMO) on-call overnight with nurse staffing.
Shepherd said Health NZ had been experiencing overnight staffing issues at Dargaville Hospital for some time, and had so far been unsuccessful in recruiting SMOs.
"Contingency plans will remain in place to ensure patient and staff safety while we continue to recruit to these vacancies. This is not a position we want to be in. However, the decisions we are taking to manage immediate operational and clinical issues are made with an absolute focus on maintaining appropriate access to health services for the community."
Health NZ was continuing to look at how it addressed long-standing workforce challenges, he said.
Earlier this month, Health Minister Shane Reti said any speculation that Dargaville Hospital could be closed down due to the lack of doctors was "utterly wrong".
In August, Dargaville members of the NZ Nurses Organisation called a rare strike to highlight their fears about a lack of doctors after hours.
Recruiting doctors is difficult at many rural hospitals, not just in Dargaville.
Rāwene Hospital, in the Far North, has not had a doctor overnight since mid-2022. Seriously ill patients are now taken directly to Whangārei Hospital, which has its own staffing and capacity problems.
Bay of Islands Hospital, in Kawakawa, has been unable to fill some weekend rosters since August this year.
While the problem is not new, senior doctors have told RNZ the shortage worsened dramatically in May this year when Health NZ cut locum pay rates by as much as 40 percent.
Locums are short-term doctors often hired to fill roster gaps. They are expensive but Northland's rural hospitals had become dependent on locums due to difficulties finding permanent staff.
RNZ has seen correspondence from a health recruitment consultant naming five doctors willing to work at Dargaville Hospital, but only if the hourly rate for locums was restored to the previous level.
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