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Doctors say violence in hospitals is increasing after a brutal attack in Wairarapa Hospital over the weekend.
Wairarapa Hospital did not have security guards on hand when a man attacked a visitor in the emergency department with a machete just before midnight on Saturday.
A 62-year-old man was taken into custody at the scene and is now facing a charge of wounding with intent to cause grievous bodily harm.
Police said in a statement the victim and the offender were known to each other, and the victim received moderate injuries.
In a statement, they said a weapon, which they confirmed was a machete, had been recovered.
Association of Salaried Medical Specialists executive director Sarah Dalton told Midday Report she was "reasonably certain there was no security staff present in the ED at that time". However, Te Whatu Ora said that was not the case.
The man was disarmed by a doctor, attendants, and the patient herself.
'Really shocking to longer-serving staff' - Association of Salaried Medical Specialists executive director Sarah Dalton
She said there were a number of people in the ED, and it must have been "really frightening" and "really stressful" for everyone involved.
She said it was not standard in small hospitals to have round-the-clock security in place in the ED.
"They may have one or more security staff on-site, but they may be far away from the emergency department," she said.
Dalton said staff at the hospital had told her this sort of thing "never used to happen", and it was "really shocking to longer-serving staff".
"Some of the newer ones kind of expect the workplace to be violent, which is a really terrible thing to have to say about our hospitals."
It was not just a matter of just beefing up security either, said Dalton.
A number of the security staff the government temporarily put in over summer were not specifically trained for hospital settings or in de-escalation, she said.
"While they were able to be there as a visible presence, they weren't actually able to be of a lot of practical help."
Meanwhile Health New Zealand - Te Whatu Ora said "security staff were present at ED at the time of the incident, and were able to attend within seconds".
Te Whatu Ora Wairarapa group director operations Kieran McCann said in a statement, following the incident, that extra security was placed in the emergency department and staff were being supported.
"We condemn all actions of violence against patients and staff. An investigation will take place into this incident to determine if there was anything which could have prevented it occurring."
Security had been temporarily beefed up security over the Christmas period, with more security on-site. That had since been removed.
But Dalton said even that was not enough.
"We need better than that," she said.
Those temporary staff were not trained in a hospital setting or de-escalation or restraint, she said, so they would not have been "a practical help" if an incident occurred.
She said a proper review was needed, and specific funding for ED security.
The Australasian College for Emergency Medicine New Zealand chairperson Dr Kate Allan said beefing up security in place after the incident did not do anything.
"The incident has already happened. The staff and other patients need it in a timely manner when the incident is actually occurring."
Allan said EDs were vulnerable in a situation like the one that took place on Saturday night and could happen anywhere in the country.
"We would like to see 24/7 in present security guards within every emergency department within New Zealand," Allan said.
"They need to be integrated and trained as part of the workforce in the emergency department so they can be proactive rather than reactive when these things go badly."
As part of its 100 day plan, the government paid for 200 extra guards across some hospitals over summer, but that finished in February.
However Health NZ was able to reallocate funding until 1 July 2024, which meant increased security at eight "hotspot" EDs and surge security as needed - such as was now in place at Wairarapa Hospital.