Six senior doctors at Nelson Hospital have spoken out about their concerns staffing levels are putting patients lives in danger. The doctors say they – along with their union, the Association of Salaried Medical Specialists – have privately raised their concerns with management for months, if not years. This is the first in a two-part series by 1News’ Jessica Roden.
Some of Nelson’s most experienced senior doctors say a lack of staff in their departments has led to waitlists blowing out, sometimes putting patients’ lives in danger.
The obstetrics and gynaecology department now has more than 1000 people on their waitlist, with 483 waiting more than the target four-month timeframe. The two senior doctors 1News spoke to said there is no way they will be able to get through this waitlist with their current staff.
They said they are doing emergency hysterectomies on women who are waiting for appointments to save their lives. Another doctor said she’s seen a patient’s cancer go from curable to incurable after they waited longer than recommended for an appointment.
While hospitals across New Zealand are struggling, Nelson Hospital is the worst in the country for how long it’s taking patients to get a first specialists appointment, something Health New Zealand admits is “unacceptable”.
Patient’s despair at specialist wait times
1News got an exclusive look into their heavy workload and limited resources. (Source: 1News)
For the last three months Nelson woman Amy Aitken has been in serious pain.
“It just feels like I’ve got a sharp knife that’s being twisted,” she said.
The 34-year-old can’t work, is taking morphine and regularly returns to the emergency department.
“I can’t do much during the day. It’s taken over my life effectively.”
Doctors originally thought it was a twisted ovary but after further investigation discovered it wasn’t. Aitken said they don’t know what’s going on.
In February she went on the waitlist for a first specialist appointment with a gynaecologist at Nelson Hospital. She was told she will be seen within 12 months, but Aitken said she can’t wait that long.
She believes her previous health issues, including with mental health, means her concerns about the pelvic pain aren’t being taken seriously.
When asked what it would mean to her if she got an appointment tomorrow, she said: “I would be amazed. I would be so happy. Just to at least have a plan”.
In a statement, Health New Zealand’s deputy chief executive with responsibility for the South Island, Martin Keogh, told 1News Aitken’s concerns are being taken seriously.
“We have genuine sympathy for Amy on her health journey and want to acknowledge the impact that delays in care have had on her, and her family, and I apologise for this.”
He said they are doing their best to improve wait times and will continue to prioritise the sickest patients first.
‘I’ve never seen that number of patients waiting to be seen’
While Aitken’s situation is upsetting, it is not isolated, said Dr Claudia Hays, who is the head of Nelson’s obstetrics and gynaecology department.
“We have over a thousand patients that are waiting for either a first specialist appointment or a follow-up appointment,” she said. “I’ve never seen that number of patients waiting to be seen.”
Of those patients, 483 have been waiting more than the four-month target time frame.
Senior doctor and consultant Dr Adelle Hanna said a lack of staff and the growing waitlist was first raised privately with management three years ago.
“We had an emergency meeting called summer three years ago because we had a hundred women that were past their 120 days – and that was seen as a terrifying number,” Hanna said.
Hays said there can be consequences of those wait times.
“The first one that we worry about the most is needing an emergency hysterectomy,” she said.
Hays said while those people would have likely needed a hysterectomy regardless — a planned procedure is safer.
“That is genuinely a life threatening situation and that’s the situation that we have found ourselves in more times than we would like.
“I can’t think of a time in my career outside of the last two years where I’ve seen or done an emergency hysterectomy for the reasons we’re now seeing and doing them.”
Health NZ admits Nelson wait times are ‘unacceptable’
On Friday, Martin Keogh sat down for an interview with 1News regarding the concerns raised by the doctors. He admitted Nelson Hospital is now the worst in the country for first specialist appointments.
“That’s unacceptable for me and the clinical teams and clearly not OK for the community we’re serving there.”
Keogh said there have been some long-standing issues in Nelson which Health New Zealand is trying to get to the bottom of.
In some instances, roles have been advertised but were unable to be filled, he said. An announcement was due in the coming weeks about more staff for hospitals across the South Island.
“We won’t be able to do everything immediately. So, where is our greatest risk? And clearly Nelson is going to be a key feature.”
Keogh said they are looking into the instances the doctors have raised regarding impact on patients, saying he’d only recently been made aware of the concerns about emergency hysterectomies.
“There’s always patients that deteriorate for whatever reason on our waiting lists. That happens right across the world. Is there is a new trend here is something we’re looking into.”
Waitlists impacting cancer prognoses – doctor
The doctors say there isn’t just one department struggling. Senior doctor and consultant Dr Suzanne Beuker said the urology department has regularly been short-staffed over the last two years as extended leave of senior doctors often hasn’t been covered.
Beuker said that has led to waitlists blowing out.
“Many patients that have been triaged to be seen within 56 days are waiting an excess of nine to 12 months to be seen,” she said.
On some occasions, Beuker was left in tears at the end of a shift.
“Certainly I have seen patients that I believe their disease has gone from curable to incurable during that waiting time.”
She said many patients aren’t even making it onto the department’s waitlist.
“Unless you’ve got a cancer or a life-threatening condition on our urology service, you will be seen in our service. Otherwise, you just won’t be seen.”
Private doctors were flown in recently for a Saturday “super clinic” to get through the urology backlog.
Beuker said extra staff across the whole department and cover for leave is needed to stay on top of it.
Life turned upside down after cancer referral delay
Daniel Walker is still recovering from a surgery, which doctors say could have been avoided.
“My GP had done it as an urgent cancer referral and they had changed it to a right painless testicle, basically, so had downgraded my diagnosis.”
An administrative staffer changed the referral. While he should have been seen within two weeks, it took nine. Within that time, the aggressive cancer spread.
Beuker said cases such as Walker’s is what the department feared would happen.
“My mind boggles why he waited that period of time,” she said.
Walker said his life was turned upside down and his mental health suffered. He said if it had been caught earlier, he wouldn’t have needed intensive chemotherapy or a second, more invasive surgery.
“I kind of feel like when I went through this that the old Daniel died in that chemo in that whole process and that this new Daniel now is someone that I don’t recognise,” he said.
Health New Zealand apologised for the distress the delay in treatment has caused Walker.
“Daniel’s referral was triaged as urgent. We acknowledge that departmental resourcing and clinical capacity, as well as the referral process, led to these delays,” Keogh said.
“Nelson Hospital had been trying to secure a locum prior to Mr Walker’s referral, as our staff member was on long-term leave. While there was not a locum in place when we received Daniel’s referral, locums were employed for periods after than time.”
Since Walker went public with his story earlier this year, he said he’s been overwhelmed by others who have reached out about their concerns regarding Nelson Hospital. While he is now cancer-free and returning to work this week, he doesn’t want anyone else to go through what he did.
If you have information about the issues at Nelson Hospital please email jessica.roden@tvnz.co.nz
