Health Minister Andrew Little has offered a reassurance to the severely sick or injured to go to hospital emergency departments despite a resourcing crisis, as he put pressure back on the country's bigger hospitals to manage patients more effectively.
Little appeared on Breakfast shortly after nurses from Christchurch Hospital’s ED appeared on the show saying a lack of beds and staff meant care was compromised and they feared patients dying or being permanently harmed in avoidable incidents.
“Our health system, if it was an in-patient that worked into my ED today, I would be triaging it as a triage one, I’d be calling a crash code, we need urgent, immediate attention. My message for Andrew Little, we need to act now, the health system is critical, we need action, we need it today,” nurse Keziah Jones said.
The Government had known about these ED issues for some time and “the critical issue is that in-patient flow”, Little said.
The questions around the lack of resources for many EDs across the country prompted Little to assure those who need to go to hospital.
Overwhelming workloads and a shortage of beds have left staff so exhausted they’re leaving. (Source: Other)
“I hear the stories of the pressure that people are under and they’re right to raise it, right to talk about it,” he said.
“That said, I want to give reassurance to everybody if they’ve had an accident or they’re hurt of injured or they need help, still go to the hospital.”
Little also put it back on hospital managers, particularly at larger hospitals, to manage patients better to make sure beds were available.
“I say to the hospital managers, you know what the challenges are, I’ve seen the data, I’ve seen the figures about presentations to EDs and the proportion of admitted and what have you, it fluctuates,” he said.
“Those hospital managers know the pressure on their hospitals, they know their staff, they know their pressure points, it is their job to manage that, to create that environment for their staff to do the best they can.”
Hospitals could cope because they had done so before, Little said as he highlighted an example from Dunedin Hospital on Wednesday when 18 patients arrived but only three beds were available.
“If you see the challenge of emergency departments as they can’t take a person who’s turned up there who needs to be admitted, find a bed for them. Then you are entitled to look to the rest of the hospital, particularly for the bigger hospitals,” he said.
“I looked at the situation in Dunedin yesterday, they needed to find room for 18 patients, when I cast around for people outside of Dunedin to say what would you do in a situation like this for a hospital that size, they said there are hospitals of the same and smaller size dealing with a bigger pressure point and they manage it because they manage that in-patient flow.
“You know the ups and downs, you know what your staff personnel requirement is, have you got everybody on board? Are you managing those patients already on the wards in an effective way to make sure you know you can meet the rising and falling changes in demand for your emergency department.
“It’s what hospital management is about, it’s what we can expect of them.”
Little listed some of the additional funding that Labour governments had made in healthcare since 2017, but said it would be some time before those investments would reduce the burden currently being felt by many EDs across New Zealand.
“In the time we’ve been in government, $5 billion in new facilities for hospitals across the network, that is taking time to build and construct, trying to alleviate those pressure points, a lot of this is taking time,” he said.
“Last year $980 million alone. In the last three years we’ve added between 2,000 and 2,500 additional personnel across the hospital system each year alone.
“We’ve seen the increase in emergency department personnel, some have increased more rapidly than others, but we’ve put that in there. We’ve funded additional nursing positions.
“We know that are more people presenting to emergency departments with mental health issues, we’re putting a massive amount into our mental health wards and services, a lot of that is upgrading facilities, that is taking time.”
The Health Minister added that hospitals in Aotearoa did not effectively act as a network as he flagged potentially making changes in this area in next month’s health reform announcement.
“I think the advice I’ve had since I’ve been minister says there is an issue with funding formulas and we know that,” he said.
“There’s also a challenge is the way hospitals and our hospital system is managed too, we have 20 effectively different managers of our 20 hospitals, trying to get some consistency and coherence across them is a real challenge.
“For example, if one hospital has got a lot of elective surgeries or planned cares and they are at capacity, it’s very hard to say actually it’s in our and the patient’s interest to have that procedure done at a different hospital.
“We’re not very good at that, managing our hospital system as a network.”
Little said he had committed to creating a nationwide body to oversee the health system as a way of removing inefficiencies in the DHB system.
“I’ve signed off on a whole heap of projects to build more buildings in the existing hospital campuses but actually what I want to start seeing is the plans to push those services who don’t need to be at hospital that people travel long distances to and push them out into the communities,” he said.
“In relation to the workforce, I’ve already committed to having Health NZ, a sort of nationwide body overseeing the health system, they would have a workforce development mandate, actually do some planning, some 10 to 20 year planning about what we need.
“Maybe some investment in training, work with immigration on those skills and disciplines we need to continue to bring into New Zealand. Actually, get a plan in place to deal with that so we’re not lurching around from one period to the next wondering where our next bunch of nurses and senior specialists are going to come from.”
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