Whangārei Hospital emergency department slammed all year round as demand for White Cross vouchers grows

Vouchers are given to people with non-urgent medical problems, entitling them to free treatment at a nearby private clinic.

Whangārei Hospital’s emergency department is experiencing year-round “surges of demand” as the number of White Cross vouchers issued to Northland patients climbs.

The number of vouchers given to patients to receive care at the independently-owned healthcare group to relieve pressure on the slammed emergency department has raised questions about why taxpayer money is being used to fund the private sector.

Te Whatu Ora - Health New Zealand issued an estimated 1500 to 2000 vouchers per year to White Cross to cover non-urgent treatments for Northlanders.

Between 200 and 300 vouchers were issued per year to White Cross for South Auckland patients, along with another 6300 vouchers per year to three additional urgent care providers.

Around 3600 to 6000 vouchers were issued to West Auckland patients.

Te Whatu Ora Te Tai Tokerau hospital and specialist services interim lead Tracey Schiebli encouraged people to see their GP or other primary care provider “unless it is an emergency”.

“Whangārei Hospital is busy all year round,” she said.

“The traditional winter peaks no longer exist, and we experience surges of demand on a daily and weekly basis.”

Whangārei emergency medicine consultant Dr Gary Payinda said emergency departments were “fully stretched”.

“If you’re in the ED on an overwhelming day, you want patients to get care elsewhere by any means necessary.

“That [voucher system] might be okay as a stop-gap measure for a couple of days or weeks.

“But what we’re seeing now is the overwhelming demand is no longer a seasonal anomaly. It’s now business as usual.”

Whangārei emergency medicine consultant Dr Gary Payinda said White Cross vouchers should only be used as a stop-gap measure for a couple of days or weeks.

However, Payinda questioned the use of vouchers, which Whangārei Hospital emergency department started giving out in 2020 under a partnership with White Cross aimed at prioritising medical care.

The scheme, introduced to Auckland City Hospital in 2004, allows non-urgent patients to receive free treatments at White Cross to help ED doctors manage their workloads and focus on those who need urgent care.

The voucher value depends on the patient’s circumstances but is designed to cover all out-of-pocket costs for non-emergency ailments like colds and flu, sore throats, diarrhoea, vomiting, bruising, swelling, sprains and small cuts.

“The money comes from all taxpayers and is going to private corporations, some which are owned by private equity, to pay for a service that should have been provided by the public sector with our tax money,” Payinda said.

“It’s a diversion, a way of streaming [taxpayer] money to private corporations.”

Between August 2022 and June 2023, 1562 vouchers were given to Northlanders seeking treatment at the Whangārei emergency department.

Payinda said he “fully understands” why Te Whatu Ora is making use of vouchers, as “it’s a way of temporarily decreasing the number of patients an ED needs to see”.

But the money could be better spent on funding more doctors and nurses to alleviate staff shortages, he said.

Though the cost per voucher varies, if each were around $100, that would be $156,000.

Te Whatu Ora confirmed each voucher is around $83, and additional intervention costs such as radiology may also be needed.

“We have to ask why we’re literally spending hundreds of thousands of dollars of public money on private corporation-owned healthcare, when that money could stay within our DHBs to pay for more nurses and doctors to see those patients,” Payinda said.

“It’s very concerning – it’s serious money.”

Whangārei Hospital’s emergency department is experiencing “surges of demand” all year round, not just during winter.

Schiebli said it was “important that EDs are reserved for emergencies only and see only the sickest people in our communities”.

“The ED voucher system is a measure in place to help manage the demand for hospital-level emergency care.

“All patients are triaged by an experienced emergency department nurse on arrival, with our sickest patients seen first ... Where clinically appropriate, triage nurses may offer patients the option to seek a free clinical assessment and treatment via their local urgent care clinic using the voucher.”

The voucher issue came to light after written Parliamentary questions from National’s health spokesman Dr Shane Reti on July 12.

Reti said the figures “show the need we have here in Northland, and [they] also show the capacity deficit that we have that EDs are unable to cope [with]”.

“They might otherwise have been able to manage those conditions, but because of a severe lack of workforce, need to pass them on for first assessment to after-hours services.

“The question needs to be raised - for that amount of money, where could they [patients] have been best placed; primary care, the ED or White Cross?

“If those were conditions suitable for primary care, then the GP and primary care would have been the best place to have them seen.

“But we have such a dire shortage of GPs, and after-hours [care] is so reduced around the country.”

Jenny Ling is a news reporter and features writer for the Northern Advocate. She has a special interest in covering roading, health, business and animal welfare issues.