Dawn Picken: Fixing the healthcare staffing crisis a matter of life and death

Hospitals throughout Aotearoa have long been under tremendous strain, writes Dawn Picken. Photo / Getty Images

OPINION

There's nothing like a front-row seat, or rather bed, for one of New Zealand's major crises.

While politicians wring their hands and point fingers, one party accusing the other of neglecting the healthcare infrastructure of Aotearoa, many of us experience serious consequences inside the story.

Maybe you, too, have been there: it's the elective surgery you wait months for, or the procedure your doctor says you need, but it's been two months, and you have yet to hear when it'll happen. Or, if you're super-lucky, like me, you get a trip to the hospital.

My GP sent me to the emergency department for blood work last month after I complained of pain and gastrointestinal issues related to chronic liver disease. She said if the tests were okay, I could return home and have a throat scope the following week.

I flunked the tests. My haemoglobin count was so feeble, I required two units of New Zealand's finest A positive and bucketloads of other pharmaceuticals to help the blood do its job.

All up, it meant four nights in Tauranga Hospital. In addition to regaining some health, acquiring two sore, pinholed arms and a body filled with IV fluids, I also learned a few things.

One of the top stories during my stay was about a woman who died after visiting Middlemore Hospital's ED in June. A recently released independent inquiry found she went home after staff told her the wait would take hours.

She returned to the hospital in an ambulance a few hours later after a brain haemorrhage, and died the following day.

On day three of my hospital stay, another woman in Christchurch Hospital's overcrowded ED died after waiting three hours for an initial assessment.

These are not isolated incidents. Hospitals throughout Aotearoa have long been under tremendous strain, not just from previous Covid admissions, but from underfunding and immigration settings that have restricted the flow of much-needed medical staff.

The National Party last month published a letter 30 Bay of Plenty senior medical and clinical staff sent to their boss claiming patients were "choosing to die" instead of travelling for treatment due to a lack of local facilities.

The letter said: "We believe that Covid is providing an excuse for delays in access to care when the true fault is years of under-investment in resources".

It listed examples of "inadequate" services due to a lack of resources including patients being diagnosed with bowel cancer who had been on its waiting lists for months longer than recommended.

Labour's Health Minister Andrew Little blamed routine, historic underfunding and said a taskforce last week made 101 recommendations to cut surgical wait times.

In my view, taskforce sounds like code for nothing's happening, though I hope that's not true.

The New Zealand doctors union has asked Health New Zealand (which has replaced district health boards) to increase New Zealand medical student numbers by 200 a year, employ medical students in their final year of training, and guarantee senior medical officer employment to doctors who complete their residency in New Zealand, according to an August media release.

Medical staff have left Aotearoa when the Government failed to grant permanent residency in a timely manner. This is lunacy. Open the pipeline, give more qualified professionals a warm haere mai and assure them they can practise medicine here as long as they like, provided they fulfil their legal and contractual obligations.

As for growing our own doctors, a proposal by Waikato University and the Waikato District Health Board in 2016 to establish the country's third medical school has languished. It may be destined to die, not unlike the hapless patients who perished after visiting overcrowded emergency departments.

On the Monday afternoon of my hospital stay, I was contemplating how much of the chocolate cake on my tray to eat when a staff member wheeled a man down the corridor. "The staff have been wonderful at the hospital here, eh?" said the patient.

Indeed. Everyone including doctors, nurses, techs who take your blood, cleaners and meal delivery people was kind and competent, despite their heavy workload. One nurse told me she was caring for seven patients (the NZ Nurses Union has called for a 1:4 ratio of nurses to patients). Despite her busy job, she was chipper and chatty and dispensed an infinite list of medications on schedule.

Yet we shouldn't punish healthcare workers for their efficiency. Just because many medical staff are coping, does not mean we wait to fix the urgent problem of chronic understaffing. Competent people should not bear the weight of the government's inaction.

As with any complex issue, no single solution exists. The people on the front lines of medicine have already told the Government what's needed, including expedited immigration, better pay, more GPs, A&Es to help unclog emergency departments, and possibly a third medical school.

Haven't we been living inside our own case study long enough? Let's take whatever steps we can today to fix the health system so no one dies tomorrow while awaiting care.

Dawn Picken has written for NZME since 2014 after a career in television news and marketing in the United States. Picken teaches in the business department of Toi Ohomai, where she shares stories of leadership and change.