Photo: Unsplash / RNZ
The health system is under intense pressure. Doctors raise the alarm about staff shortages and burnout. Patients share stories of long wait times and delayed diagnoses. Meanwhile, telehealth services appear increasingly to be filling the gap.
The coalition government has set targets to shorten wait times in EDs and elective treatments.
The health minister has admitted the sector is in "crisis", and RNZ has reported Te Whatu Ora documents show the cost of building new hospitals and patching up old ones is expected to escalate to nearly $47 billion over the next decade.
The government has fired Te Whatu Ora's board, and the new commissioner Lester Levy is tasked with reining in what the Government says is oversight and overspend problems.
Have you been affected by health worker shortages or budget cuts? Share your story at: hamish.cardwell@rnz.co.nz.
Levy said Health NZ is "totally bloated" with bureaucracy and says there will be cuts to back office staff.
RNZ is committed to telling the full story, from the hospitals, waiting rooms, and living rooms of Aotearoa.
Check out our reporting of just some of the most important issues so far:
Long wait times
Wait times in public hospitals for cancer treatment, specialist appointments, and surgery all got worse in the first three months of the year, according to a recent report.
A Lower Hutt GP practice made headlines with patients waiting months for an appointment. A second doctor has been hired at the clinic, which has had to rely on mostly virtual appointments.
More cancer patients were waiting too long for potentially life-saving radiation treatment. Health New Zealand's latest quarterly report showed cancer wait times have worsened, with more than 18 percent of patients waiting longer than a month to start any treatment.
Levy has said wait times are his top priority.
Staff shortages
The country is short of healthcare workers across the board.
It's been reported midwifery has the greatest shortfall, with an extra 300 graduates needed a year. It's hoped a midwifery school set to open next year at the University of Waikato will help address the shortage.
Emergency departments nation-wide were also experiencing critical workforce shortages, Minister Shane Reti said in July. But he wouldn't commit to increasing budgets, saying "there is overspending, not underfunding".
Some hospitals were using telehealth services when they weren't able to have a doctor onsite overnight. And some after-hours medical services in were on the verge of collapse, with overworked GPs saying they could no longer provide cover.
Westport's hospital was closed over Wednesday due to staff illness.
Meanwhile, some hospital admin staff are not being replaced, forcing stressed doctors and nurses to pick up their workload on top of their own.
Post code lottery
Doctors working in rural communities say their patients are dying at higher rates from preventable causes just because of where they live.
Research published by Hauora Taiwhenua Rural Health Health Network shows they have poorer health - but less access to healthcare.
Reti says improving rural health is a government "priority", and Levy has launched a review to work out where in the country staffing shortages are most severe.
Workplace pressure
A study by the Royal New Zealand College of General Practitioners shows part-time doctors are working full-time hours to get through their workload.
Problems with hospitals and health infrastructure
Dunedin hospital staff have reported hundreds of incidents of theatre instruments not being properly sterilised, according to a Te Whatu Ora report leaked to RNZ.
It found the unit is not fit for purpose, and about 500 incidents a year were reported where "instruments intended for theatre use have been found to be contaminated".
Meanwhile, a Health New Zealand report shows about $47bn of investment in hospital infrastructure is needed over the next 10 years.
That is the equivalent of two or three new Dunedin Hospitals every year for the next decade, and even this massive investment won't be enough to meet projected demand.
Funding issues
The Budget allocated new money for training more doctors, increasing access to breast screening and putting security guards in emergency departments.
But free prescriptions were axed by the coalition government, except for those under 14, pensioners, and Community Service Card holders, to save just under $71m.
Pharmac's budget would top more than $6 billion over the next four years to fill a shortfall of more than $1.7b left by the previous government, but the drug-purchasing agency admitted any new medicines would require an additional cash injection.
In May, the Association of Salaried Medical Specialists found funding was failing to keep pace with inflation or demand.
Issues at the top
The government installed Health NZ's board chair Lester Levy as a commissioner, replacing the organisation's board. Prime Minister Christopher Luxon said the change was in response to "serious concerns around oversight, overspent and a significant deterioration in financial outlook".
Disruption to services
Junior doctors and blood service laboratory workers have participated in multiple strikes in 2024.
Members of the New Zealand Nurses Organisation have held public rallies, and home support nurses have also walked off the job, seeking pay parity with their Te Whatu Ora colleagues.