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.

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Manukau Urban Māori Authority (MUMA) is welcoming the government’s health reforms as an important first step to improving Māori and Pasifika health in south Auckland.

But some in the health sector say the jury is still out on what will be achieved in Counties Manukau.

Under the reforms, the country’s 20 district health boards have now been replaced by Te Whatu Ora (Health New Zealand).

The new Crown entity will be responsible for running hospitals, primary and community health services.

The government says it will allow for more consistent delivery of health services nationwide and help stop the postcode lottery people face accessing healthcare based on where they live.

The reforms also include the establishment of Te Aka Whai Ora (the Māori Health Authority) to improve indigenous health which will work in partnership with Health NZ.

Muma chairman Bernie O’Donnell has seen the country’s district health boards work first-hand, as a member of the now-defunct Auckland DHB.

Greater responsibility for Māori
He said establishing a Māori Health Authority would give Māori greater responsibility for the delivery of their own health services.

“For too long the health system hasn’t addressed the wellbeing of Māori, or those at the bottom of the cliff,” O’Donnell said. “The reality is we couldn’t continue with what we had. Something had to be done and this is it.”

He said critics of the health reforms are defending a system which had to be replaced.

“The old way the DHBs were run didn’t work for our people. For too long it’s been non-Māori telling us what’s best for us.”

He said ongoing issues left by the Counties Manukau DHB, such as Middlemore Hospital’s under-pressure emergency department and its workforce shortages would all have to be addressed under the changes.

“But what we’re expecting is that Māori and Pasifika health in south Auckland will get better under the reforms,” O’Donnell said.

However, he admitted there’s a lot at stake.

‘Time will tell’
“If that doesn’t happen we won’t have achieved anything of significance,” he said. “But only time will tell.”

Yet not everyone is as certain as O’Donnell on what impact the changes will have.

Turuki Healthcare chief executive Te Puea Winiata said there were still a lot of unanswered questions about the reforms.

Winiata said the creation of the new authority dedicated to indigenous health is an important first step.

But she said it was vital that the new entity had the ability to make its own decisions and help support Māori self-determination.

“The resourcing of the Māori Health Authority is going to be critical to its success,” she said.

Many reform attempts
Winiata said she had worked in the health sector for the past 30 years and in that time had seen a number of attempts by the government of the day to restructure the health system.

She said it was hard to predict what impact the health reforms would have in south Auckland.

“But I think in 12 months’ time we will be able to look at what changes have been made and see what’s been achieved.”

Local Democracy Reporting is Public Interest Journalism funded through NZ on Air. Asia Pacific Report is an LDR partner.

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New Zealand health officials are investigating a mystery case of covid-19 who spent time in hospital and interacted with seven police officers before she knew she was infected.

The woman was swabbed as a precaution when she went to Middlemore Hospital yesterday for a non covid-related reason.

She spent two hours at the hospital’s emergency department and short stay ward, and the positive result came back after she had left.

She had also had contact with seven police officers on Wednesday morning.

The officers were wearing masks but have been stood down as a precaution.

The hospital staff were wearing full protective gear and are deemed to be low risk, but 36 patients were being asked to isolate.

New Zealanders are being told to keep covid-19 testing numbers up over the weekend ahead of next week’s alert level decision.

Monday alert levels meeting
Cabinet will meet on Monday to decide whether any parts of the country can move down an alert level.

More than 14,000 swabs were processed yesterday.

Director-General of Health Dr Ashley Bloomfield said 7000 of those tests were from the Auckland region.

“This continues to be giving us confidence about the outbreak, and whether or not it is controlled, and one thing I would like to emphasise is this weekend is critical that we get high testing numbers.

“So anyone who is symptomatic, particularly in Tāmaki Makaurau, please do go and get a test.”

The numbers

• There are 11 new cases of covid-19 in the community today.
• There are now 879 total cases, with 288 cases having now recovered.
• There are 29 unlinked cases, including six from today.
• Six new cases are in managed isolation and two historical cases were reported today.

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

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New Zealand today reported one new community case of covid-19 – the first in five days.

There was no media conference today. In a statement, the Health Ministry said the source of the community case was still being investigated.

Auckland Regional Public Health Service has identified all close contacts, who have been isolated and tested.

The other case has been detected in a recent returnee in a managed isolation facility.

The number of active cases continues to fall with five recovered cases today, leaving a total of 67.

Four people are in hospital with covid-19 – one each at Auckland City and North Shore hospitals and two in Middlemore. None of them are in ICU.

The ministry said 34 are imported cases in isolation and quarantine facilities, and 33 are community cases.

Total confirmed cases 1460
The total number of confirmed cases of covid-19 is now 1460

More than 900,000 tests have now been carried out in New Zealand, with another 8359 processed yesterday.

There were no new cases of covid-19 reported in New Zealand yesterday – the first day with zero cases since early August, when the Auckland cluster was revealed.

The last community case before today was reported on Monday.

This article is republished by the Pacific Media Centre under a partnership agreement with RNZ.

• All RNZ coverage of covid-19
• If you have symptoms of the coronavirus, call the NZ Covid-19 Healthline on 0800 358 5453 (+64 9 358 5453 for international SIMs) or call your GP – don’t show up at a medical centre.

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