New Zealand's emergency departments are in "crisis", according to a new report, amid soaring patient numbers, more seriously unwell people needing hospital care, and a "chronic shortage" of beds.
The Australasian College for Emergency Medicine's State of Emergency report said around 1.4 million patients checked into EDs in 2024 and 2025, increasing 21% over the past decade. It said this "far exceeded" the 13% population growth during the same period. Māori patients visiting the ED also rose by 49%.
The number of people requiring urgent and complex care also rose across the same period, with 66% of patients triaged into more urgent categories.
The report found 97% of discharged patients and 56% of admitted or transferred patients met the ED six-hour benchmark target.
Meanwhile, between 2014 and 2024, inpatient bed supply fell from 2.7 to 2.5 beds per 1000 people.
The report found that workforce shortages were putting additional strain on EDs, making it harder to meet patient demand.
It said the system was "failing Māori", with persistent health inequities.
While funding is budgeted at $33.4 to $34.2 billion by 2026-27, the report said more was needed to meet previous shortfalls, demand, and population growth.
The report also identified some improvements, including a growth in new specialists in the emergency specialist workforce, making up 7.5%.
Increased funding in Nelson, where new doctors were employed, has reduced demand – but some pressure still remains.
It recognised the Government's work to modernise hospital IT systems, and said it was "crucial" the plan be effectively implemented.
The report also said that while alternative services like urgent care, telehealth, and virtual care may be easing pressure, "they do not address rising levels of patient urgency".
The report made a series of recommendations, including increased and sustained investment in inpatient and aged care capacity, supporting initiatives to grow the emergency specialist workforce, improving Māori health equity through cultural safety training, and ensuring health budgets and performance frameworks align with Te Tiriti o Waitangi obligations.
Ahead of the election, the ACEM called on political parties to commit to actioning the recommendations.
"This report is a reality check and a call to action," ACEM Aotearoa New Zealand council chairman Dr Michael Connelly said. "We want to see emergency care front and centre of every party's health policy."
"Our health system is in crisis. Our EDs are operating at or above capacity every day. That is not sustainable for our workforce or our patients, who continue to face longer wait times for the care they need.
“More of us are living longer, with more complex health needs, and many of us need an inpatient hospital bed, not just the emergency department.
"We see the result of that every day, with patients stuck in our EDs because there's nowhere upstairs to send them, and the flow through the entire hospital is backed up.”
Health Minister responds
Health Minister Simeon Brown told 1News he valued his ongoing engagement with ACEM on how to improve emergency care.
"Emergency department staff do an incredible job under real pressure, and I'm grateful for the care they provide every day."
He highlighted efforts made by the Government, including a reduction in time patients spent in the ED.
"Results since June 2025, where the report’s data ends, show we're making progress," Brown said.
"In the April to June quarter this year, 76.3% of patients were admitted, discharged, or transferred within six hours, up from 73.9% a year earlier and 68% in September 2023 under Labour, despite more people attending."
He also discussed the Health Infrastructure Plan, the delivery of 140 beds through fast-built wards at five of the country's busiest hospitals, major rebuilds, and more than $680 million in health capital investment in the recent budget.
"We've also boosted funding for aged residential care by around $79 million this year, and providers are now expected to take admissions from hospital over the weekend, so older patients can move into the right care sooner and hospital beds are free for those who need them.
"We're also extending urgent care and making it easier to see a GP, so fewer people need to go to ED in the first place."
Brown acknowledged there was still work to do, "which is why now is the time to build on that progress, not risk sliding back to where we were just three years ago".
"National will keep working with emergency doctors and ACEM to make sure patients get timely care when they need it."
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