A year ago the government was warned that urgent action was needed to avert a health crisis:.
Newly released information shows that Health Minister Andrew Little ignored warnings a year ago about the risk of crippling health shortages, National’s Health spokesperson Dr Shane Reti says.
“An urgent letter on behalf of all 20 DHBs was sent to health officials in July 2021 warning of impending health workforce shortages and requesting immediate changes to immigration settings.
“After receiving the letter warning of a looming storm about to hit the health sector, Andrew Little decided to ignore it and pushed on with his health restructure.
“The letter clearly outlines the danger of critical workforce shortages, the need for overseas trained staff, and an expected increase in demand in emergency departments. Unfortunately, this gloomy prognosis from the sector has come true.
“The Health Minister is failing at his core responsibility of ensuring New Zealanders have access to health care, all because he is distracted by his ideologically driven desire to restructure the health bureaucracy.
“New Zealanders are now missing out on health care because Minister Little has failed to act on warnings from the sector. Meanwhile, New Zealand is missing out on nurses to Australia because the Government has refused to put them on the fast-tracked residency pathway. Now we are dangerously 4,000 nurses short and have a health sector slowly falling apart at the seams.
“Andrew Little needs to explain why he didn’t listen to pleas from the sector last year about the coming workforce shortage, and why he didn’t take urgent action to bring more workers in from overseas.”
The government keeps boasting of the money it’s poured into health but it hasn’t gone where it’s needed:
We now know why Andrew Little isn’t resourcing Emergency Departments – because he has spent it all on consultants and contractors, National’s Health spokesperson Dr Shane Reti says.
Last year the Ministry of Health reportedly hired 407 consultants and contractors but with a month still to go in the current reporting year that number has exploded to 1,359 – nearly 1,000 more.
“Our hospitals are at breaking point. We are desperately short of 4,000 nurses and the Government has hired 1,000 consultants to prop up their flailing health restructure.
“This is a slap in the face for aged residential care who are desperate for 1,000 nurses, DHBs who are desperate for 3,000 nurses, clinics who are desperate for 1,500 GPs and specialists who are 1,500 short.
“New Zealanders deserve better. Andrew Little needs to explain to patients waiting more than eight hours at Middlemore ED why an extra 1,000 consultants is more important than ED doctors and nurses.”
Dr Reti spoke outlined the failings in yesterday’s General Debate:
Thank you, Mr Speaker. We now know why more than more than 36,000 people are waiting more than four months to see a specialist. We now know why emergency department (ED) wait times have increased, with some people waiting more than 32 hours. We now know why we have a health workforce shortage—4,000 nurses, 1,500 GPs, and 1,500 specialists.
Because Andrew Little ignored the cry for help a year ago when a district health board (DHB) chief executive wrote, on behalf of every DHB, pleading for help, a letter with dire warnings and actions that were needed immediately to “avert a health crisis”. A year later, the chickens have come home to roost.
Let’s see if Andrew Little takes a general debate call this afternoon, 48 hours out from significant health reforms, which would be the convention with such a big structural change. Let’s see if that happens, and if he wants to defend what I’ll lay down on the table today. The Minister is trying to say he only found out about this letter a month ago. I do not believe that, and I want to challenge that on at least two points.
First of all, if the Minister didn’t know about the letter, he should have known about the letter. This letter was on behalf of every single chief executive in the DHB sector—that is, the most senior executive group in our hospitals—and they deserved his attention.
Secondly, very senior people in the Minister’s own ministry also received the letter—the ministry he is supposed to have oversight for. It was also sent to the acting Deputy Director-General of Health Workforce New Zealand on 28 July last year. It’s a very senior person, the Deputy Director-General, inside the Ministry of Health.
I contend that Andrew Little should have been aware, or was aware, of this letter from DHBs a year ago and he did nothing. The Minister was warned a year ago and did nothing. His track record in this sort of MO is well known. I’m inclined to remember ICU beds—warned about it, did nothing, and the dire consequence that came from doing nothing around ICU beds, and particularly building new ICU beds, particularly in Auckland.
The letter sent by 20 DHBs a year ago had multiple warnings. First, the health system is buckling, with some sites in code red. Directly from the letter: “You will be aware that our hospitals are also experiencing very high levels of occupancy at present, and some sites are even in code red, where they are deemed to be at extreme levels. This is obviously an unsustainable situation and places even more pressure on our existing workforce. We are very concerned about this situation and for the potential for further deterioration if there are no changes to assist with at least securing the existing workforce from 20 DHBs.”
Secondly, the letter also says, “We are also experiencing increased presentations in emergency departments.” They even sent graphs of what the occupancy rate looks like inside the EDs, showing the increasing trend towards what they call “extreme occupancy” across emergency departments a year ago, and here we are today with emergency department times increasing.
Point three, what the letter also says: “In order to respond to surge, the system will have to redirect workforce from areas like planned care.” That’s code for 36,000 people waiting more than four months to see a specialist. What’s really poignant is their last summary of that: “This will have long-term impacts on the health and wellbeing of New Zealanders.”
Point four, and here’s the immigration bit—here is what 20 DHBs were urgently asking for, which resonates what my colleague Erica Stanford has been talking about for a long time, in which we have a petition up at the moment. This is the summary to the letter: “Therefore, DHBs seek your immediate attention to (1) ensure our current overseas-trained staff can have a direct and prompt path to residency.” That’s not two years for registered nurses; that’s a direct and prompt path to residency. “And (2) that overseas health professionals are facilitated to enter New Zealand as required to avert a crisis in the health sector.”
Clearly that has failed. This was a warning a year ago that the Minister had and he did nothing. There’s now no money for ED nurses; no money for ED docs. Because what we also know is that instead of building the health workforce, the ministry has employed up to 1,000 new consultants—not even in the past year, just in the past 10 months is what the written parliamentary question shows. No money for ED nurses, no money for ED doctors, but plenty for up to 1,000 consultants.
It’s interesting looking at the list of consultants: corporate services, 78; data and digital, 728; the DG’s Office, 40; Health Workforce New Zealand, 10. I think that kind of sums it up right there. Just 10 in this bloated, excessive list of consultants. I rest my case.
The government kept telling us the Covid-19 lockdowns and other restrictions imposed on us were to stop the health system from being overwhelmed.
But in spite of those unprecedented losses of freedom, the health system is in crisis.
. . . The health system is in meltdown. Call it a crisis, or don’t. It is collapsing around us.
Healthcare staff are at the end of their rope – undervalued and underpaid for years, the wave of strikes is a cry for help. Most are distressed because they know people will die because they can’t access treatment.
As the system buckles, there is incredulity that Health Minister Andrew Little is pushing ahead with a bureaucratic overhaul. Doctors are being asked to work – unpaid – on groups advising the ministry on how to bed in the new regime. No-one seems to know how it will work – the changes are yet another burden that the workforce cannot absorb. . .
People who move can’t register with a general practitioner and those who have one wait days, sometimes weeks, for an appointment.
Emergency Departments are overwhelmed, there’s a dire shortage of beds in wards and elective surgery has to be postponed time and time again.
Some of the blame can be placed on Covid-19 but the pandemic isn’t responsible for all the problems.
It’s the government that didn’t respond to the warning from the DHB’s.
It’s the government that wouldn’t loosen immigration settings to enable foreign health professionals here to gain residency and those overseas to come in.
It’s the government that’s wasted time, energy and millions of dollars on restructuring the system instead of addressing the problems facing services and the people who deliver them.
It’s the health workforce and people needing services who are paying a very high price for their inaction over the problems and distraction with restructuring.