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Nina Su became a doctor to help people, but that feels increasingly difficult.
When the 28-year-old arrives for a night shift in Auckland Hospital’s emergency department, she checks an electronic whiteboard.
It lists patients waiting for treatment. Some have been there for hours.
“There will only be five or sixdoctors overnight,” says Su, a paediatric and emergency doctor.
“There could be 40 patients waiting to be seen - that’s at the beginning of the shift. People will still continue to come in overnight.”
Those critically unwell are seen, but others - a person who hits their head and needs observation, for example - can wait a long time.
Such delays are now common in Australasian emergency departments, Su says, and risk harm.
“Someone with an aortic dissection or an aneurysm, or something like that - they could suddenly deteriorate. And we may not be able to see that if the wait time is too long.”
Even if that workload pressure vanished, the job would still get her down. That’s because many patients sicken because of factors she cannot treat - overcrowded, damp housing, and poor diet and lifestyle driven by grinding, inter-generational poverty.
She sees kids with rheumatic fever, for example, a third-world disease closely associated with poor housing and poverty, and which can lead to heart disease or even death.
Medical teams treat patients, who return to the conditions that made them sick in the first place.
A shortage of GPs and underfunding for proper, intensive primary care means when those people get sick again, they often return to the ED - a sort of revolving door.
Auckland City Hospital and others are under growing pressure. Photo / Sylvie Whinray
Su’s partner Connor Ayliffe lent an ear to her post-work complaints and eventually suggested they make a podcast so others could hear about what was actually happening in the health system.
They called it Revolving Door Syndrome. In each episode, Su interviews a guest - an air ambulance paramedic, a Māori paediatric doctor, a criminal defence lawyer specialising in legal aid - about their experience, and views on what could help improve things.
The conversations are frank and revealing.
“We now have nurses who are just starting on the ward, everyone is too busy to teach them, and within six months it is, ‘Oh, you are the most senior person on tonight,’” says emergency nurse Dr Natalie Anderson in episode 9.
“Even though I work in the ED, I would love to see far more money going into GPs and primary health. Because you can prevent a lot of those patients coming to me - if they just had five minutes longer with their GP, or they could see a GP this week…”
Revolving Door Syndrome has a growing audience, and Su’s platform is getting bigger: she is today being announced as an election candidate for The Opportunities Party (TOP), standing in Epsom.
TOP was founded by outspoken economist Gareth Morgan. After he ended his involvement it got just 1.5 per cent party vote in 2020, and is now led by Raf Manji, a former investment banker and Christchurch City councillor.
Su is running to give voice to healthcare workers, many of whom, she says, “feel afraid to speak out about the issues that they see” (and are expressly forbidden without hospital management and communication team sign-off).
She voted TOP in the past but doesn’t feel it was a wasted vote, despite the party not entering Parliament.
“A wasted vote is people voting for parties that don’t align with their values.”
Nina Su is an emergency doctor who will take on Act's David Seymour in Epsom. Photo / Alex Burton
All the same, the party’s size means it can be hard to get through to people, many of whom recall Morgan’s 2013 “Cats to Go” conservation campaign which encouraged people to not replace cats when they died.
“When I ask, ‘What have you heard about The Opportunities Party?’ A lot of the answers are, ‘Isn’t it the one with the guy with the cat [thing]?’” Su says.
“And I have to be like, ‘Oh, you know, once upon a time. Yes, it was. But we’ve got a fresh team, fresh faces, fresh approach. That was old news.”
TOP’s headline policy covers income tax cuts, including tax-free on the first $15,000 of income, which the party says will be funded by a land value tax. TOP also wants a $3 billion community housing development fund.
Epsom is the country’s smallest electorate and one of its most wealthy, encompassing Parnell, Newmarket, Remuera, Epsom and Mt Eden.
Act Party leader David Seymour has held the seat for nearly a decade.
He received 19,500 votes in 2020, beating Labour’s Camilla Belich (10,276) and National’s Paul Goldsmith (6397).
Act Party leader David Seymour is the Epsom MP. Photo / Dean Purcell
Su and Ayliffe live in the electorate, in a rental near Cornwall Park. She grew up in Warkworth, one of two children to parents who emigrated from China in the early 1990s before starting a family.
Money was tight in her primary school years, before her parents got better work - her dad as a lab technician, her mum packing newspapers for the Rodney Times.
Su moved to Auckland to study medicine and has stayed. She loves her job but after only five years already feels burnt out - exhaustion shared by over 90 per cent of respondents in a recent survey by NZ Women of Medicine.
“Healthcare has been chronically underfunded for decades,” Su says of the reason for that crisis.
“People have just been pushed to the absolute limit over the last couple of years … morale is really low. A lot of people are wanting to quit.”
That would worsen already alarming vacancy rates, across many areas including nursing. There’s growing pressure to work longer shifts.
Su thinks she’ll always be a doctor, but sees working in medicine full-time as “increasingly difficult”.
“I think a lot of people will be looking at exit strategies or ways to reduce their clinical hours. It’s simply too hard.
“If we don’t talk about it, it’s just not going to get better.”
That straight talk marks her podcast and, in the coming months, will feature on the Epsom election trail.
The battle for Epsom
Act Party leader David Seymour will be heavily favoured to retain Epsom, which he has held since 2014.
National list MP Paul Goldsmith is running as a candidate again. National has in the past encouraged its voters to back Seymour, as a way to guarantee a potential coalition partner when Act returns to Parliament.
Labour’s 2020 candidate in Epsom, list MP Camilla Belich, has put her name forward to contest Mt Albert, a seat vacated by Jacinda Ardern.
Belich is up against Helen White to be Labour’s candidate, and the selection meeting is next Saturday.
Nominations to be Labour’s Epsom candidate close on March 31.
The Green Party hasn’t selected an Epsom candidate yet. Its 2020 candidate was Kyle MacDonald, a high-profile psychotherapist and mental health advocate.
