The NZ health system needs more than extra doctors and nurses

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Dave Armstrong is a playwright and satirist based in Wellington.

OPINION: After a stressful fortnight working up country, my wife and I were looking forward to a quiet week. Unfortunately, hours after arriving home, my wife had developed a particularly angry rash on the side of her face.

Down to the private after-hours centre and after a couple of hours, the excellent doctor explained to my wife that the inflammation was close to her eye, which could potentially damage her vision. They didn’t have the resources to treat this, so she was dispatched to the hospital A&E department.

When we arrived at 10.30pm, the pleasant receptionist warned us of a very long wait. How long? No one was sure. The room was so busy we had to sit in the corridor behind it, making it difficult to hear patients names called out. We needn’t have worried. It was hours before my wife was even seen by a nurse. Many patients were fast asleep – they’d been waiting a while.

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At all times, the staff were pleasant and helpful, even though stretched to the max. As we approached midnight the police brought in an older woman. She had an awful bump on her head and I wondered if she was intoxicated as she was not always coherent. The already-busy receptionist gave her some water, a family member was alerted, and the police left as soon as they could – no doubt because they had another emergency to attend to.

When Bump on the Head brought out a cigarette to smoke, the staff politely asked her to refrain. After a bit of abuse (“hey b…h”) she put it away. An orderly offered to wheel her outside. Later she was brought a coffee and some food. She drank the coffee and threw the food on the ground.

Meanwhile, another woman in a terrible mental state was screaming at a very calm staff member. She had been trespassed from her flat by her landlord and was waiting on emergency housing. Did she need medical treatment? Possibly, although it was her mental state that was of most concern.

“At all times the staff were pleasant and helpful, even though stretched to the max,” Dave Armstrong writes.

Kathryn George/Stuff

“At all times the staff were pleasant and helpful, even though stretched to the max,” Dave Armstrong writes.

Meanwhile, another patient, a young guy with an injured ankle that the staff had elevated for him, managed to calm down the two upset women, and thank a fellow patient who handed out bread buns to various patients and staff members. Elevated Leg’s kindness was repaid by Bump on the Head singing Pōkarekare Ana and Emergency Housing telling him he had lovely eyes. A homeless guy I recognised from Newtown periodically wandered through. Shortland Street this wasn’t.

The glacial pace continued through the night. There was a constant stream of ambulances in the background coming and going. At some stage a naked woman, covered in a blanket by an attending staff member, was led in. Drug overdose? I’ve no idea.

By about 6am the numbers of waiting patients had decreased dramatically and the noisier problem ones – called Gomers by some in the medical profession (Get out of my emergency room) had been dealt with.

By about 10am, Covered by Blanket was fully clothed. There were now just four patients remaining from the night before and a handful of new ones. Around 11.30am, Elevated Leg hobbled out – it was a dislocation and not as bad as first thought. “Keep hassling the staff to make sure your wife gets seen, but in a nice way,” he said. By midday, over 13 hours after having arrived, my wife had finally seen a most apologetic doctor. She was still not entirely diagnosed but had medication prescribed and with eyes intact.

“Hospitals are the crisis point for a health system and the A&E is the crisis point for hospitals, so it reveals the cracks in both the health system and our wider society,” writes Dave Armstrong.

Kathryn George/Stuff

“Hospitals are the crisis point for a health system and the A&E is the crisis point for hospitals, so it reveals the cracks in both the health system and our wider society,” writes Dave Armstrong.

The staff – not just the doctors and nurses, but receptionists and orderlies as well – were incredible. They endured more insults in 13 hours than I did in a month of teaching in a tough school.

What became apparent is that as well as addressing the doctor and nurse crisis – which is essential to get down waiting times – we must also address the inequality, poverty and homelessness crises. Hospitals are the crisis point for a health system and the A&E is the crisis point for hospitals, so it reveals the cracks in both the health system and our wider society.

And the problem isn’t just a Wellington one. The entire Hokianga region in Northland now no longer has an after-hours service thanks to a doctor shortage, and 40,000 nurses have left the British NHS in the last year.

Dave Armstrong: “The staff ... endured more insults in 13 hours than I did in a month of teaching in a tough school.”

Jericho Rock-Archer/Stuff

Dave Armstrong: “The staff … endured more insults in 13 hours than I did in a month of teaching in a tough school.”

I know there is wastage in the health budget, but when politicians talk about cutting bureaucrats, do they mean the ones I witnessed desperately trying to get people with the greatest need seen first? After seeing the cultural factors at play, I suggest politicians think twice about abolishing the Māori Health Authority; it could be a chance for systemic change.

We both got home and turned on the news. Apparently, National’s tax cuts for the highest income earners are going to be very different to Liz Truss’ disastrous UK ones. We turned it off and went to bed for some much-needed sleep.