Source: Radio New Zealand
One of the treatment areas in Nelson Hospital’s upgraded emergency department. Samantha Gee / RNZ
- The Office of the Auditor-General has found no issue with the wait list numbers for first specialist appointments at Nelson Hospital.
- It comes after two unions raised concerns about placeholder clinics being booked for patients, who had not been seen. They still want to know why “dummy clinics” are being used.
- Health NZ welcomes the findings, which it says shows its administration approach had not affected first specialist assessment health target reporting.
The Office of the Auditor-General says it has found no evidence of wait list numbers being misrepresented at Nelson Hospital, but the unions which raised concerns say it does not explain why “dummy clinics” were set up to manage patients.
Last July, the Association of Salaried Medical Specialists and the New Zealand Nurses Organisation flagged that people at Nelson Hospital were possibly being removed from the waiting list despite not having been seen by a specialist.
At the time, Labour health spokesperson Ayesha Verrall said the hospital was booking “ghost appointments” to make it look like their targets were being met.
Assistant Auditor-General Russell Bates said it looked at the issue as part of its annual audit of Health NZ and found patients had been removed from the waiting list only when they attended a specialist appointment, or for another valid reason.
He said the Nelson Marlborough District had allocated 24 patients, who had been on a wait list for more than two years, to a “dummy clinic” with a “do not contact” marker.
It served as a holding code while actual additional clinics were arranged.
Bates said the explanation was that it changed the status of patients from “unbooked” to “booked” but it had found patients remained on the waiting list until seen, or until they were removed for another valid reason.
“We can confirm that all 24 patients allocated to a dummy clinic were still included in the first specialist assessment waiting list as at 31 March and 30 June 2025, and the ‘referral date’ had not been altered. These patients are removed from the waiting list only when they attend a specialist appointment, or are removed for another valid reason.
“In other words, the process of setting up a dummy clinic was an administrative action that did not affect patients’ waiting list status for the purpose of reporting on the health target.”
Health NZ said it welcomed the Office of the Auditor-General’s finding that there was no misrepresentation of waiting list numbers and its administration approach had not affected first specialist assessment health target reporting.
It had contracted consulting firm EY to conduct an independent review of the accuracy of the first specialist appointment health target reporting.
Unions still seeking answers
Association of Salaried Medical Specialists executive director Sarah Dalton questioned why “dummy clinics” had been used and if other hospitals were also using them to manage patient numbers.
“Effectively they’re still explaining themselves by saying this is a way of grouping patients together who need to be seen, who are breaching the waiting times and who we can’t see because we’re not properly staffed and resourced to do this in a timely fashion.
“It doesn’t really matter what you call it. If people are still waiting somewhere on a list and there’s no ability to see them because of resource and constraints, and we know that’s the case at Nelson, they’re rationing access to care.”
She said that was not the fault of the clinicians but a decision made by the health system and the way it was funded and organised and that some people were missing out on care, or waiting “way longer” than was clinically advised.
Waiting lists were matters of public interest and decisions made by Health NZ on how they were managed should be open for public scrutiny, she said.
The Office of the Auditor-General said Health NZ had contracted EY to conduct an independent review of the accuracy of the first specialist appointment health target reporting and the union was yet to see a copy of it.
It is said to address some of the administrative challenges encountered by Health NZ arising from variations across districts.
“If you look at the distribution of access to care for certain conditions around the country, it’s not equitable, it’s not fair. There is further disadvantage if you’re a woman, if you’re Māori, if you’re Pasifika, if you live in a smaller centre, if you live rurally, your access to care is not as good,” Dalton said.
“We still don’t have any kind of a plan or answers from Health New Zealand about how they plan to properly staff and resource all of their hospitals so that people can access care in our public health system within a reasonable time frame.”
Dalton said she understood work was underway to improve wait times and access to care in Nelson and Marlborough, but there was still a lot to be done.
“Although there is some positive change, such as an uptick in numbers of junior doctors being employed at Nelson, there is a long way to go.”
NZ Nurses Organisation chief executive Paul Goulter said its members had raised the issue out of concern for their patients.
“Using an internal code of ‘do not contact’ with five minute appointments didn’t pass the sniff test and concerned the Office of the Auditor-General enough to investigate,” he said.
“It still makes little sense and Te Whatu Ora has yet to explain why Nelson Hospital had to set up ‘dummy clinics’ to establish additional clinics.”
Goulter said NZNO would continue to support its members to advocate for their patients.
Sign up for Ngā Pitopito Kōrero, a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
– Published by EveningReport.nz and AsiaPacificReport.nz, see: MIL OSI in partnership with Radio New Zealand
