KEY POINTS:
A plan to place GP clinics next to hospital emergency departments to cut patient waiting times faces a panning at a medical conference this week.
Several small hospitals already run versions of the "co-location" of services, with big-city hospitals also considering similar set-ups.
Wellington Hospital looked closely at the idea but dropped it because of health funders' fears they might pay twice for patients' primary care.
Last night, Health Minister Tony Ryall told the Herald that the GP scheme had formed part of a National discussion paper from September last year, examining wider issues relating to emergency departments.
But although there was a place for primary healthcare providers to help to ease the workload in emergency departments, the GP co-location scheme was not it.
Western Australia emergency specialist David Mountain said there was no evidence that GP clinics near hospitals helped reduce the patients being held up in emergency departments while awaiting admission.
"There are certain areas out of the metropolitan areas, with a high paediatric workload, where after-hours clinics may take the edge off the very crowded ED waiting rooms. But again, that's not going to sort out the underlying problem of access block and overcrowding that kills patients and causes very bad outcomes."
Dr Mountain will speak at the Australasian College for Emergency Medicine conference beginning in Wellington today.
GP-type patients were often thought to be the cause of overcrowded emergency departments, he said.
Instead, they typically comprised 10 to 15 per cent of an emergency department workload, but accounted for less than 3 per cent of resources as they were easily treated.
Emergency department overcrowding was a symptom of an overcrowded hospital, and the solution lay in providing more acute-ward beds, more facilities for rehabilitation and aged residential care, and more chronic-disease care to keep people out of hospital.
Australian research put the death rate from hospital overcrowding at similar to the road toll.
Emergency department heads at Auckland City and Wellington Hospitals believe the same would apply to New Zealand - about 400 deaths a year. Those deaths were caused by failures such as delays in treatment for heart attacks, too long waits for antibiotics and overlooking trolley-bound patients waiting in hospital corridors.
Mr Ryall said the emergency department was the "barometer" of a hospital, and ensuring patient flow was the key to lowering waiting times.
One way to ensure patients received timely treatment and admission, if necessary, could be to tie patient flow to hospital bosses' performance assessments, he said.
Health authorities are investigating the college's claims - which came with a demand for a 15 per cent increase in hospital ward beds - and will report to Mr Ryall within weeks.
Their recommendations are likely to include whether there should be:
* A target maximum of six hours in the emergency department for any patient.
* A policy that no patient be left in emergency department corridors waiting for admission to a ward.
Auckland City Hospital's emergency department clinical head Tim Parke said authorities were "nudging towards a consensus on no corridors and six hours".
His Wellington Hospital counterpart, Peter Freeman, said patients being left in hospital corridors for up to a day was a "daily event".
"It's not pleasant for the patients or the staff."
Dr Freeman praised Auckland City Hospital for banning the practice of leaving patients in hallways.
