Return to regionalised health system will ease staff shortages, Health Minister says

A return to a more regionalised health system will ease the dire staffing problems facing Northland's rural hospitals, Health Minister Shane Reti says.

Dr Reti was in the north on Friday to visit a newly built aged care centre and a new medical imaging clinic, both in Kerikeri, but his visit came against the backdrop of a staffing crisis in the region's rural hospitals.

Dargaville Hospital made national headlines earlier this month when it was no longer able to find enough doctors to fill its rosters, leaving a telehealth business - which uses a remote doctor to see patients via an internet video call - to fill the gap.

The sickest patients are now taken directly to Whangārei Hospital, which is already facing serious overcrowding in its emergency department.

Rāwene Hospital stopped its after-hours doctor service in 2022, and Bay of Islands Hospital in Kawakawa is also facing intense staffing pressure.

Doctors have told RNZ that pay cuts of up to 40 percent for locums, or fill-in doctors, are contributing to the shortage because some have opted not to return given the reduced pay rates.

Reti said his main focus at the moment was Dargaville Hospital, but Health New Zealand was keeping him informed of the situation at the region's other rural hospitals.

He said the government's move to bring back a more regionalised health system, which included the recent appointment of four regional deputy chief executives, would ease the problem by allowing more local decision making.

That included a commissioning budget and flexibility to set pay locally, instead of having to go "cap in hand" to Wellington.

The staff shortages at Dargaville and other hospitals were, however, not a matter of money, he said.

"We have funding for the roughly 10 positions that are vacant across our three main rural hospitals. It continues to be a workforce issue, something we've confronted for many years. I'm reassured both by the commissioner and now by the regional deputy chief executive, that they're working really hard … We just need to get the warm bodies into those roles."

Ensuring medical staff had all the services they needed, such as radiology, was also vital to attracting workers to rural hospitals.

Reti said the more regionalised approach would also help reduce the so-called postcode lottery, in which some regions had better healthcare services than others.

As for the use of telehealth to make up for a lack of doctors in Dargaville, Reti said it was complementary to other forms of care, but could never completely replace a face-to-face doctor's consultation.

He acknowledged low morale was a problem in the rural workforce but said that, too, would be lifted by increased local-decision making, along with other moves such as introducing funding so GPs could refer patients directly for scans instead of having to go through a specialist.

The new aged care centre at Metlifecare's Oakridge Villas Reti visited was due to open in mid-September.

The two-storey, $38 million complex will house up to 70 residents in 50 care and hospital-level suites, along with 15 rooms in a secure dementia unit.

The care centre fills a need in Kerikeri where the provision of care beds has not kept pace with the town's retirement village boom.

Reti said having a whole spectrum of care on one site meant older people did not have to be separated from their social networks or partners once they were no longer able to live independently.

The dementia beds in particular were a rare and essential resource, he said.

Reti also visited a new imaging clinic, including an MRI scanner, on State Highway 10.