A union has raised the issues of wait-times, understaffing, and resources at the hospital "for years", its spokesperson says. Photo: RNZ / Nate McKinnon
HealthNZ's chief clinical officer has revealed the agency was only aware of one of the cases of patients becoming sicker - and in one case, dying - following delays in being seen at Nelson Hospital before senior medical staff went to the media.
Richard Sullivan said HealthNZ's recently released Quality and Safety review pointed to "issues of access into our health system, issues into primary care and surgery, issues with FSA (first specialist assessment)" across the country.
"We've been aware of those for a long time," Sullivan said.
But he said HealthNZ was not aware of the "multiple issues of patient care" at Nelson Hospital until media reports over the weekend.
"That's why we are sending in our team to go and look at what has been shown in the media and therefore what we need to do about it."
Nelson Hospital was a great hospital with great staff that delivered great care, but there were concerns about getting to be seen in primary care, seeing a specialist or having surgery, Sullivan said.
Health New Zealand was taking the matter "very seriously", had sent a senior staff member to Nelson on Wednesday with more to follow, and was developing a plan to improve on areas of concern, which would be in place within "a couple of weeks", he said.
Photo: RNZ / Nate McKinnon
Union unimpressed
But the union representing senior doctors is accusing the government of window dressing.
Association of Salaried Medical Specialists executive director Sarah Dalton said the union and its members had "persistently and consistently" raised the issues of wait-times, understaffing, and resources "for years," and had been "routinely either denied or ignored".
Dalton said it was not yet clear exactly what the team would do.
Sarah Dalton Photo: LDR / Stuff / Kevin Stent
She said Health NZ told the union and its members that senior clinicians would be sent to Nelson to look at things such as access to planned care, waiting times, clinical quality issues and staffing.
Clinicians knew what was needed, and needed to be listened to and supported with appropriate resources so they could do their jobs.
Dalton said management at district, regional and national level needed to listen to what clinicians had to say and the resourcing so the hospital could be safely and appropriately staffed, and patients and families could access care in a timely way.
There might be challenges along the way, but it was not that complicated in a sense - they were resource starved.
The site was a problem, that's a complicating factor, and it was not easy or fast to fix, but the fact remained there was significant understaffing. she said.
There were staffing issues that could be addressed relatively quickly that were not being addressed.
Dalton said the minister's comments that HealthNZ would be looking to see what could be outsourced to the private health system missed the issues at play.
"Private hospitals don't deal with overloaded EDs and they don't deal with overloaded medical wards. One of the challenges Nelson Hospital has in terms of bed block is that it is significantly overwhelmed with medical patients - they are patients that are sick enough to be in hospital but don't need operations. Those things need to be dealt with in our public system.
"Simply suggesting you can bat things off to private [hospitals] and everything will be fine is magical thinking. It's also more expensive for the taxpayer to send things off to private," Dalton said.
Long wait despite 'unbearable' pain
Aleisha Hosie was already in severe pain when she was referred to Nelson Hospital's gynaecology department.
She received a letter saying her appointment would be within two months, but when she called five months later, she was told the department was only seeing emergency cases or those that had been on the waiting list for more than a year.
The increasingly "unbearable" pain was forcing her to take time off work, and interfering with caring for her two children. With the help of her family Hosie saw a private gynacologist.
She was diagnosed with severe endometriosis that had caused her ovaries, uterus and bowel to fuse together with scar tissue.
Hosie said endometriosis had never been raised by doctors within the public system.
She underwent a hysterectomy in the private system, as she had still not heard from Nelson Hospital a year after her referral.
She was lucky her family was able to assist her to meet the cost, but said others didn't have that option.
"It's creating a two tier system. If you have the money to go private, then people are being forced to do that, but if you don't what do you do? You wait and you suffer."
Hosie said it was not just the physical pain, but also the mental toll of waiting, following up and pushing to be seen.
"It's scary that people are waiting so long and their conditions are worsening. They're suffering and their families have to watch them suffer as well."
Provisional Health NZ data showed 483 patients had been waiting more than four months for their first specialist appointment with the Obstetrics and Gynaecology department.
Health NZ said it acknowledged the impact delays have on patients and their families, and apologised to those affected.
Deputy chief executive Te Waipounamu Martin Keogh said Health NZ shared the doctors' concerns over staffing across Nelson and Marlborough Hospital services which has impacted patient wait times, including "challenges" in recruiting senior and junior medical staff, as well as "demand and capacity challenges" in specialities such as vascular, obstetrics and gynaecology.
"I want to reassure staff we are listening and already have a range of initiatives underway," he said.
Health NZ provisional data shows vacancies for 29 senior medical officers, 56 junior doctors and 51 nurses across the region.
Late last year the former Health minister Shane Reti committed $10.6 million to an upgrade of Nelson Hospital's emergency department, as part of a broader plan to redevelop Nelson Hospital - the plans for which have not yet been released.
In August, the government scrapped the Labour government's $1 billion redevelopment plan, which would have seen a large new 255 bed acute services building and a new emergency department, [https://www.rnz.co.nz/news/national/525284/health-minister-backtracks-on-plans-for-nelson-hospital-rebuild
in favour of a series of smaller buildings completed in a staged roll-out].
Announcing the revised plan in August, then-minister Reti said the new master plan would would go before Cabinet by the end of 2024, with the timeline for completion likely be ahead of the previous 2031 deadline.
It was hoped construction of the new inpatient building would start in early 2026 with construction expected to take between two and a half and three years.
Earthquake strengthening work for the George Manson and Percy Brunette buildings was underway, with work scheduled to be finished by the end of this year.
A government review of clinical hospital facilities in 2020 found the George Manson building to be the worst in the country.
Workers there have complained conditions in the building were unbearable, with leaking windows, overheated rooms, and bits of ceilng prone to collapsing.
Sign up for Ngā Pitopito Kōrero, a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
