Burnt out nurses are looking for "greener pastures", their union says, as the most significant change to Aotearoa's health system in decades is now days away.
Doctor Richard Stein and the Nurses Organisation's kaiwhakahaere Kerri Nuku spoke to Breakfast about the health system's struggles on Tuesday. Stein is also a board member of the Hutt Valley DHB, which will be disestablished in three days.
Nuku said chronic under-staffing in hospitals was affecting nurses as well as all levels of the country's health system.
"The whole entire system is backed up and under this enormous pressure," she said.
"When you fear going to work, because you don't know whether you've got enough staff, you hope and you hold your breath to get through that shift - that's not okay."
The nurses union kaiwhakahaere said under-staffing and "increasing patient demand" meant fatigued nurses were "looking for greener pastures".
Stein agreed and said Covid-19 was the "straw that broke the camel's back" as he believed the health system had been under-resourced for years.
"It's a ripple effect that affects everybody just down from the hospital specialists to the nurse down to the GP, and unfortunately down to the patient."
He said it was taking a long time for patients to see specialists and that most DHBs had put a significant number of elective surgeries on hold. Stein said nurses and GPs needed to be valued more as part of the system, with commensurate pay.
"We need to value our nurses, we need to value our staff, we need to value our GPs - it all starts at the bottom," he said.
"[Nurses] call the doctor, but they're the ones that recognise when there's a problem. I spoke with an ED doctor yesterday, who told me if he doesn't have nurses, he says he can't perform in an emergency department."
Both Nuku and Stein agreed that the Government's health reforms to disestablish district health boards was a step in the right direction, but needed continual support.
The Government's health reforms will see a new centralised Health NZ agency replace most functions of the country's 20 district health boards.
"We need to make sure that the systems are in place to really support it," Nuku said. "At the heart of any healthcare system, we must consider the voice of the community in patients."
Stein believed the acknowledgement that "things had to change" was a positive step, but that it wouldn't be an "easy fix". He said he was encouraged by the presence of clinicians on the boards of both new agencies.
"I'm hopeful they can change things, but it's not going to be an easy fix, and it's not something that's going to happen overnight."
New Zealand's health system has been increasingly under pressure with high numbers at hospital emergency departments due to Covid-19 and the early onset of winter respiratory illnesses.
Health Minister Andrew Little provided a statement to Breakfast addressing the strain on the health system.
"It's widely accepted the health system is under serious pressure from years of neglect and under-investment," he said. "That's the system we inherited."
"We are proud of and grateful to our health system for its world-leading Covid-19 response, but the pressures of the pandemic combined now with the impact of a bad flu season confirm why the system has to change," he said.
"We're putting billions of dollars into rebuilding hospitals and upgrading IT systems. We've also funded thousands more nurses for public hospitals and lifted pay for tens of thousands of health workers, but we need to change the system at its roots too.
"This is a Government of quality public health. We know there is more to do and we're leading the change, to make sure we have a health system we can be proud of for generations to come."