Te Whatu Ora’s new winter health plan fails to address workforce shortages and staff burnout in Aotearoa New Zealand, frontline healthcare workers say.

The organisation launched its 24-point plan on Wednesday, saying it would help hospitals and GPs cope with an expected surge in patient demand over the coming months.

Under the plan, people with minor ailments will be able to be assessed by a pharmacist and given free or subsidised medication in line with if they had visited their GP.

Family doctors will also be able to refer patients for X-rays and ultrasounds in a bid to reduce hospital admissions.

Regional and national escalation plans will be in place to help improve hospital capacity by “diverting resources and patients within and across regions to support under-pressure facilities”.

But a doctor from Middlemore Hospital’s emergency department, who spoke on condition of anonymity, said while diverting patients and resources sounded “good in theory”, there needed to be the staff available to deliver that plan.

There was so much burnout among doctors and nurses, she said.

“You can’t flog a dead horse.

Staff ‘not available’
“In practice these escalation plans involve going through a checklist of different resources that can be provided to help, but you then find out they aren’t available — due to staffing issues.”

A nurse from the hospital’s ED agreed chronic workforce shortages would prevent many of the proposals ever working.

“It all sounds all great, but where is Te Whatu Ora finding all the staff to do these things and how are they going to do it in a healthcare system that is already understaffed and in crisis?”

Giving pharmacists a greater role to play could also be problematic as they were also busy and were not trained to diagnose patient ailments, the nurse said.

In February, Te Whatu Ora identified Middlemore Hospital as one of eight national ‘hotspots’ needing extra support before the winter flu season.

Former chairperson Rob Campbell admitted the workforce shortages plaguing Middlemore’s ED would not be addressed in time for the flu season.

It followed comments from frontline healthcare workers who said the hospital’s ED was haemorrhaging staff and they were concerned about its ability to function during winter.

‘Doing what we can’
In a statement, Te Whatu Ora (Counties Manukau) interim lead of hospital and specialist services Dr Vanessa Thornton said while there had been growth in staffing numbers nationally, it needed to continue to grow its workforce.

“We know that pressure from shortages across our workforce is being felt on the frontlines of our health system. We can’t fix those shortages quickly – but are doing what we can to alleviate pressure and get more staff into our hospitals and other services.”

She said that includes making it easier for internationally qualified staff to work here and assisting qualified nurses to return to practice.

Local Democracy Reporting is Public Interest Journalism funded through NZ On Air. It is published by Asia Pacific Report in collaboration.

Article by AsiaPacificReport.nz

South Auckland’s poor turnout for the 2018 Aotearoa New Zealand national census could have cost the region $130 million in health funding.

And, according to an expert, that cash could have helped tackle the area’s battles with diabetes and obesity.

Te Whatu Ora Health New Zealand said the defunct Counties Manukau District Health Board lost $130m in health funding in its last four years due to the low turnout in the area during the 2018 census.

Information from the five-yearly stocktake helps determine how billions of dollars in government spending is allocated across health, education, transport, infrastructure and other services.

Counties Manukau has more people with diabetes than any other health region in the country.

Te Whatu Ora (Counties Manukau) Director of Population Health Gary Jackson said additional money would help fund programmes to battle two issues affecting many people in the region.

He said there were 52,000 diabetics in Counties Manukau and that figure was growing by 2000 people a year. It is also home to 19 percent of all New Zealanders in the most extreme BMI group.

Only 71 percent response
Figures released by Stats NZ this week show only 71 percent of people in South Auckland have so far completed the census in 2023, compared to 83 percent nationwide.

Te Whatu Ora Chief Financial Officer Rosalie Percival said getting people to provide their details was vital to ensure areas like Counties Manukau got the healthcare services they needed.

“Health providers know about the people who turn up at their door needing care — but they have no other way of knowing about the presence of people who haven’t recently needed to use the health system,” she said.

“The data gained from the census helps to inform important decisions about planning for the needs of local areas and subsequently healthcare spending.”

However, Buttabean Motivation (BBM) founder Dave Letele said getting people to complete the census was not easy.

Letele, who is potentially standing for Te Pāti Māori this year, was an ambassador for Census 2023 and was involved in a social media campaign which kicked off late last year to get more people to take part.

“There’s a massive distrust between our people and the government and that’s what we need to overcome,” Letele said.

Wary about personal information
He said as a result a lot of people were wary about sharing their personal information with authorities.

“But it’s not just something you can throw money at to fix it.”

Deputy Government Statistician and deputy chief executive for census and collection operations Simon Mason confirmed the turnout at the last census in 2018 was poor in Counties Manukau.

“That is why it is critically important that people complete the census — so their communities are counted . . .”

Mason said the 2023 event was designed to address barriers to participation, including having more collectors and alternate formats for people to complete it and support a wider range of people.

A spokesperson for Stats NZ said it would still have field teams collecting people’s responses until May 3 and will be running census support events until June 4.

Pacific Media Watch reports that the Counties Manukau health population is ethnically diverse with the largest Pacific population and second largest Māori popukation of any New Zealand health board.

In the 2018 census, 16 percent of the population served by CM Health identified as Māori, 22 percent as Pacific, 28 percent as Asian and 34 percent as NZ European/other groups.

Local Democracy Reporting is Public Interest Journalism funded through NZ On Air. It is published by Asia Pacific Report in collaboration.

Article by AsiaPacificReport.nz

“I thank Mr Campbell for his contribution since the establishment of Te Whatu Ora last year.”

In a statement, Campbell said the removal from his position was “an inappropriate reaction to statements made in my private capacity”.

“I have spoken to [opposition leader] Christopher Luxon who has accepted my apology for any personal offence my statements may have caused. He accepted my apology.

“I have also apologised to Minister Verrall for any difficulty which my statements may have caused for her and the government.”

Campbell defends actions
Speaking to RNZ Checkpoint, Campbell continued to defend his actions.

“I’ve received a letter from the minister which responded to a letter from my lawyers, indicating that she has removed me from that position as chair of Te Whatu Ora. I think that’s a mistake and an overreaction to the statements I made in a private capacity but nevertheless that’s what she’s done,” he said.

“I think I’m entitled to make comments as a private citizen, which I did in the LinkedIn post.

“And secondly, the suggestion is that I’ve somehow got offside with the opposition, which given that I spoke to Christopher Luxon earlier today, we discussed the issues. I made an apology to him for any personal offence he had taken, he accepted that apology. We had a very nice discussion about it.

“So I don’t believe there’s any issue there. I’ve seen Richard Prebble from the ACT Party saying that he believes I have the right to make statements of this kind.”

He said the comments that he made were on a public forum, but he made them in a private capacity.

“I didn’t make those statements as chair of Te Whatu Ora … I always have to have regard to the interests of Te Whatu Ora and I don’t see anything in the statements I’ve made which was in any way damaging to Te Whatu Ora.”

Strong commitment to kaupapa
“The comments showed my political position, but there is nothing in the code of conduct which suggests you should not do that,” he said.

Campbell said emphasised his strong commitment to the kaupapa of the Pae Ora legislation and the work which Te Whatu Ora and Te Aka Whai Ora were doing to implement that legislation.

“I have devoted huge energy and time and involvement to that end. I am disappointed that I will not be working directly with the thousands of health sector staff, patients and whānau with whom I have been actively engaged. My support for them is undiminished.

“The principle of working in Tiriti partnership to achieve equity in the lives of all New Zealanders is core to my beliefs and I make no apology for that.”

Campbell would not rule out taking legal action over the matter saying it was one possible line of action.

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz

The parents of a New Zealand baby at the centre of a legal dispute that has made global headlines will not be appealing against a judge’s decision to hand guardianship of the child to the High Court.

The four-month-old — known only as Baby W — requires urgent open heart surgery, with both blood and blood products required for the operation and potentially its aftermath.

Te Whatu Ora/Health New Zealand took the case to court because the parents refused to allow blood transfusions from anyone who might have had the Pfizer covid-19 vaccine.

The NZ Blood Service does not differentiate between blood from vaccinated and non-vaccinated people, saying there was “no evidence that previous vaccination affects the quality of blood for transfusion”.

A judge on Wednesday ruled in favour of Te Whatu Ora, allowing the surgery to go ahead with whatever product the NZ Blood Service provides. Doctors, having been made agents of the court for the surgery, said on Wednesday afternoon they would be ready to operate within 48 hours.

The family’s lawyer Sue Grey and high-profile media supporter Liz Gunn said this morning there was no time to appeal against the court’s decision, but they had confidence the child would “get the best possible care with the best, safest blood” because “the government cannot afford anything to go wrong for Baby W as the world is watching”.

“The priority for the family is to enjoy a peaceful time with their baby until the operation, and to support him through the operation,” the pair said in a post on the New Zealand Outdoors and Freedom Party Facebook page.

Grey co-leads the party.

The baby will be in intensive care for up to a week and under Te Whatu Ora’s guardianship possibly until the end of January, allowing time for their recovery. The doctors were told to keep the parents “informed at all reasonable times of the nature and progress of [the baby’s] condition and treatment”.

Te Whatu Ora has been approached for comment.

Judge’s ruling expected
The ruling should not have come as a surprise, University of Otago bioethics lecturer  Josephine Johnstone told Morning Report on Thursday.

“This may seem like a very 2022 case and it is in many ways, but it connects to lines of decision over time where there have been disputes about what’s in the best interests of a child that has very serious medical needs,” she said.

“So this is consistent with previous cases around the refusal of blood products for children whose parents are Jehovah’s Witnesses… or refusal of medical care for cancer treatment for children whose parents have alternative health and science[ views, which is sort of similar to this. In many ways it’s consistent with those decisions. It’s not really a break in that way.”

Johnstone said the parents’ authority over their child’s health and upbringing was being limited in only a very minor way.

“The parents still have all of the other decision-making authority that parents have. And parents do have enormous latitude to make decisions about how to raise their children — what religion to raise them, what kinds of beliefs, what kinds of home to create, what kind of traditions, they have enormous decision-making power about children’s [medical treatment], but it’s not unlimited.

“In very rare cases where it’s a life-and-death situation, we can expect the courts to step in — and that’s exactly what happened.”

Johnstone’s view was backed up by Rebecca Keenan, a former nurse who now works as a barrister, specialising in medical law.

Put child ‘firmly first’
“[The court has] put the child firmly first and have gone by the evidence and supported the health board,” she told Morning Report.

“From reading the judgment, you can see that the parents have been taking their baby out of hospital, against medical opinion, and there’s obviously been a real breakdown in the relationship between the parents and the medical staff.”

Wednesday’s judgment outlined a meeting in late November during which the parents’ support person “proceeded to pressurise the specialists with her theory about conspiracies in New Zealand and even said that deaths in infants getting transfusions were occurring in Starship Hospital”.

Johnstone said while having a support person in meetings with medical staff was a right, it was clear in this case they were not helpful.

“One has to imagine that the involvement of some of the anti-vaccine campaigners has escalated not just this case at the national level, but even the discussions between the family and their medical team, so that’s explicitly mentioned in the case and is definitely a factor in how things must have got to the point where a court order would be needed.”

While not an unexpected ruling, Johnstone fears it might further strain the relationship between parents with alternative views on medical matters and their doctors.

“Any family who has these views and has a very sick child, their healthcare providers are going to have to work that much harder to keep them engaged and keep their trust … a big challenge,” she said.

Pleased over care
Speaking to RNZ’s First Up earlier on Thursday morning, Deputy Prime Minister Grant Robertson said he was “pleased” Baby W would soon be getting the care he needs.

“Nobody underestimates the emotion and the challenge and the difficulty here, but we have to do what’s right for the child.”

The case has made headlines globally, with coverage on BBC News, CNN and The Guardian.

This article is republished under a community partnership agreement with RNZ. 

Article by AsiaPacificReport.nz