Gisborne Hospital. Photo: RNZ Pacific / Sela Jane Hopgood
This story has been corrected - senior doctor Alex Raines' name was spelled incorrectly.
Senior doctors at Gisborne Hospital have written to MPs and Te Whatu Ora calling for urgent action over critical shortages across departments, leaving just a single doctor in some specialisations.
Tai Rāwhiti now has the highest senior medical officer vacancy rate in New Zealand, which doctors say is the result of years of under-investment, and now exacerbated by recent hiring restrictions and budget cuts.
On Thursday, Labour MP for Ikaroa-Rāwhiti Cushla Tangaere Manuel questioned Health Minister Shane Reti in Parliament on the staffing crisis at the hospital.
"What is his response to the senior doctors in Tairāwhiti, an area with the highest proportion of Maori, the highest trauma rates per person and the highest levels of deprivation, who wrote to ministers 'you are failing to meet your obligations'," she said.
The latest data from Te Whatu Ora shows Tairāwhiti has a senior medical officer vacancy rate of over 30 percent - the highest across all health districts.
Senior doctor Alex Raines, speaking on behalf of over 30 doctors who collectively written to decision makers, said things had got to a critical point.
"Most of our departments are significantly short, some have essentially 10 to 12 percent of the staffing that they should have," he said.
Raines said the hospital currently had one half-time radiologist, one ophthalmologist, one dentist, and just a third of the number of anaesthetists it should have.
He said its operating theatre was at half capacity on some weeks, with just around 15 surgery slots, due to the shortage of anaesthetists.
Raines said one of the anaesthetists spent 50 nights on call this year - double the amount they were supposed to be working.
The paediatric ward was also struggling after one doctor retired and another took long-term sick leave, he said.
"The remaining staff had so much pressure on them that we've now had additional staff leave, and they're down to less than half the staff they need to have to keep their service running.
"Which of course means that the children of our region are unfortunately having longer and longer wait times to be seen for referrals and then of course, that means the remaining staff are having to cover a 24-7 call schedule, with just a few of them which is just not sustainable."
Raines said the single eye doctor who was on a 0.8 full-time equivalent role is concerned about his patients.
"He's raised examples of folks who are losing their vision because they aren't able to get in and be seen in a timely manner"
Te Whatu Ora's hiring-freeze of non-frontline roles made matters worse, with doctors having to pick up the slack, Raines said.
"I'm working a significant portion of my time every week as a recruiter to try to get junior doctors here, because we have a junior doctor shortage as well, I spend a significant amount of my time every week dealing with IT problems, because we have inadequate IT support, so that impact has been significant."
On Thursday, Reti told Parliament help was on its way to Gisborne Hospital.
"Health NZ CEO has met with senior staff, local management team are working with international recruitment team on critical vacancies requiring focused approach to swift onboarding,
"Health NZ is assigning HR resources to help Tairāwhiti to develop a retention and recruitment plan specifically for the district and Health NZ's move to a more regionally based model will be an important step to ensure Tairāwhiti can access support from other hospitals for specialist services as needed," he said.
But the minister has made no commitment to calls from doctors to lift recruitment restrictions for Tairāwhiti or to reduce vacancy levels to 10 percent within 12 months.
"Both Health New Zealand and I are committed to overcoming the longstanding issues which have impacted on healthcare in the region," he said.
Last week, Te Whatu Ora chief executive Margie Apa met with senior staff at Gisborne Hospital.
She said they were working on a range of strategies to maintain the best care for patients in Tairāwhiti.
"I see our move to a more regionally based model as the first step in this process where Tairāwhiti may need more support from other hospitals for some specialist services," she said.
However, the director of the Association of Salaried Medical Specialists Sarah Dalton said that alone would not solve the issue.
"A regional approach is not going to solve issues that the Tairāwhiti district faces, they already have a really dispersed community and very high demand.
"The people of Tairāwhiti, of the East Coast deserve good face to face care, with people who are committed to living and working in that area, yes there are some services that will always need to be provided from outside of Gisborne... but for the bulk of the care that people need here, it needs to be provided locally by local people," she said.
Dalton said it was unsustainable for the hospital to rely heavily on locum cover, and that it was an inefficient use of funds in the long term.
She was calling for more incentives for doctors to work in Tairāwhiti.
"It is an area that clearly needs incentives provided to clinicians... they need to have better terms and conditions than those who choose to live and work in urban areas, and the difficulty of the work there and the difficulty of recruitment needs to be recognised."
Dalton said the hospital has felt further strain, after the region's largest GP practice - Three Rivers Medical Centre - recently cut its after-hours and weekend service and closed its books to new patients.
Te Whatu Ora said the newly appointed deputy chief executive Cath Cronin would meet with the Tairāwhiti senior medical group next week to make further progress on addressing the issues doctors had raised.