Many years ago Peter Dryburgh, then surgeon superintendent at Kaitaia Hospital, announced that the front doors were to be locked at night, to protect staff from the violence that some people - visitors, for goodness' sake - had begun offering. It would be fair to say that Kaitaia was appalled. Denying automatic access to the hospital 24/7 was a sign that the town had reached a very low ebb indeed. Other hospitals around the country were no doubt already barricading their staff inside at night, but that was no consolation.
Kaitaia might still take some small consolation from the fact that it's worse in the major centres. Hospitals now routinely employ security staff, and even that isn't enough. It has become so bad in Auckland that the Waitemata District Health Board has begun issuing its security staff with body cameras.
That might encourage some people to behave themselves, although the more plausible motive would be to enable the gathering of evidence for prosecutions.
The DHB began spending money that would have been better spent on medical services after a surge in reported violence, including a nurse who was allegedly strangled and others who were punched, one being assaulted badly enough to require surgery. Both those assaults were committed by patients.
A security guard reportedly suffered a broken leg whilst trying to "de-escalate" a patient, while another patient reportedly punched five staff members at North Shore Hospital's emergency department, and others punched holes in walls. Patients allegedly threatened staff with weapons, and a health care assistant was kicked in the groin.
June alone saw 186 incidents of 'aggression' reported within that DHB, six a day, one every four hours, up from 45 in June last year.
The DHB insisted that there had been no increase, attributing the spike to "additional reporting." Certainly no one is denying that many incidents are not being reported, but those that are represent a very ugly iceberg.
The PSA, which reckons the DHB is more focused on recording incidents than doing anything to stop them, has warned that someone could die. The DHB's response to that was to employ more security guards and introduce 'safety gear,' as is already used by some prison officers, police and parking wardens.
CCTV cameras have been installed, hospital staff and community workers have been issued with 'security alert systems,' and the emergency department now has a security guard of its very own. Staff are also expected to undertake unspecified 'basic training,' with additional training for emergency department nurses. Presumably that means self-defence.
According to the New Zealand Nurses' Organisation, part of the problem is that North Shore's emergency department has become a "dumping ground" for those who are drunk, drugged or struggling with mental health issues. Acting Minister of Health Jenny Salesa's response was that DHBs were expected to take steps to ensure the safety of their employees. That was helpful.
Drug and alcohol abuse are undoubtedly a source of much of the violence, but such abuse is just a symptom. What we are seeing is a stark reminder that there are now two New Zealands, the political treatment for which is a more generous, less punitive welfare system.
The division between the haves and have nots might be attributed to money, but that too is a symptom. This violence stems from frustration, from what some call a disengagement from society, and rejigging welfare by the further redistribution of 'wealth' isn't going to fix it.
At the risk of sounding like a broken record, the fundamental solution is to ensure that every child in this country gets the education they need to participate in society, not necessarily as a bilingual rocket scientist but as an adult who can read and write, who can see the benefits of gainful employment, who aspires to achieving whatever is within their ability and desire to achieve. The sort of aspirations that were once universal, and were taken for granted.
Jacinda Ardern said in New York last week that she wanted every school in New Zealand to be the best school in the world for every child. Some undoubtedly already are. Some are the polar opposite - and that won't be the school's fault. What we must do is focus on the very basics; we need to cease accepting that many children do not benefit from what, despite everything, remains a very good compulsory education system, that so many of them are doomed, from conception, to suffer the same fate as their parents, and are destined to grow into the sort of people who try to strangle the nurses who are doing their best to care for them.
We were told recently that 45 per cent of New Zealand children do not meet the 'regular attendance' definition by turning up at school for at least 90 per cent of a year's half-days. Almost half of the children in this country are regular truants. And when a Hamilton principal tells her students that truancy can carry a very high price she is castigated, not only by adults who should know better but by some of her own students, and in some cases their woefully misguided parents.
Perhaps we should reassess just what it is that primary schools, in particular, are expected to teach these days and get back to the basics. And more importantly, start doing a much better job of ensuring that every child is sitting in front of a teacher every day. Give today's kids a sound basic education, give them hopes and belief, show them what they can aspire to if they make the most of the wonderful opportunity that is theirs for the taking, and maybe they'll never see the inside of an emergency department.
And if they do, maybe they won't attack the nurse.
