The last - and now leaving - permanent gastroenterology doctor at Palmerston North Hospital says there needs to be a shift in how they are trained and retained if hospitals are to avoid shortages.
Dr James Irwin said there has been "a domino effect" over the past couple of years - the hospital was funded for six specialist gastro doctors, and he had been the last one left until he announced his departure.
"There were six of us. Then we had some illness, and a period of time with an inability to recruit. I suppose at the end of that time one of my colleagues felt that things weren't changing, and it wasn't a place that he wanted to continue to work in and so he left. Then it was left to us with a domino effect, and it got worse and worse as people left," he explained.
He said there were tasks that had to be done regardless of dwindling workforce numbers.
"Normally in a department, you share that amongst your group, but as people leave, you're left with it. Yeah, so it's hard," he told Breakfast.
Asked about his decision to leave, Irwin got choked up as he explained it was not one he made lightly.
"I feel really guilty about it, and it's really sad," he said.
He said the issue was one that "requires change".
"Retention's the way to fix it, and we unfortunately were not able to do that. We were trying hard to recruit for 18 months prior to the first person leaving.
Irwin said doctors "flying in and out from outside the region is not going to provide a long term solution".
"Te Whatu Ora is responsible for providing healthcare to all New Zealanders, and that includes people in the provinces, and from where I sit, from my viewpoint, doing that is going to require a number of people appointed to live in Palmerston North, and work locally.
"I also consider that we need to recruit local people, so people that are trained in New Zealand. Our health workforce is reliant on many overseas trained people, and we're very grateful for the service they provide. But we also need New Zealand trained doctors to work in our hospitals."
Health NZ responds
In a statement, Health New Zealand said one new gastroenterologist had accepted a position at Palmerston North Hospital and was expected to begin in September 2026, with additional candidates currently progressing.
The service had experienced changes to its specialist workforce in recent years due to retirements, illness and resignations.
Executive regional director of the central region Chris Lowry said patient safety remained "the top priority".
"We want to reassure our community that essential gastroenterology services are continuing, and patients with the most urgent clinical need are being prioritised and cared for," said Lowry.
“We acknowledge this has been a challenging period, and we are focused on strengthening the service and improving access as quickly as possible.”
It said clinics and endoscopy services would continue to run with the support of locum and visiting specialists, and that active recruitment was underway to rebuild the specialist workforce.
"Recruiting specialist doctors is challenging across New Zealand and internationally, particularly for regional hospitals. We are continuing to explore all options to attract clinicians to MidCentral and build a sustainable workforce for the future."
Alongside recruitment, a range of actions are already in place to support the service in both the short and longer term. These include maintaining services with temporary specialist support, continuing to prioritise patients based on clinical need, strengthening clinical teams, and improving referral and triage processes.
HNZ recognised the impact this situation may have on patients and their whānau.
"We know some people are waiting longer than we would like, and we understand this can be frustrating. We are committed to improving access and keeping patients informed," she said.
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