Our hospital is too small, says doctor

A senior doctor is warning Wairarapa Hospital is too small for the region’s growing population.

His comments come as new numbers provided by Te Whatu Ora show the hospital was operating close to capacity over the winter months, with occupancy at 94 per cent during June.

Other winter months showed similarly high numbers, with occupancy rates at 80 per cent in July, 84 per cent in August, and 89 per cent in September.

The combined inpatient bed occupancy rate given is for the medical-surgical wards, high-dependency unit, and the paediatrics, rehabilitation, and maternity wards.

The ED had also been under increasing pressure.

Only 66 per cent of people were seen in the ED within six hours of arriving in June, 72 per cent in July, 70 per cent in August, and 59 per cent in September.

Norman Gray, clinical lead of Wairarapa Hospital ED, has previously said working conditions and staff shortages are impacting patient care.

“There’s poorer outcomes for patients for sure,” he said.

“There are not enough resources to meet demand.”

However, Kieran McCann, the group operations director for Te Whatu Ora – Wairarapa, said high occupancy rates in winter are not unusual and reduce over summer.

Although he acknowledged healthcare capacity issues are a challenge for Te Whatu Ora, McCann said the hospital is just one part of the system providing healthcare for patients.

Clare French, a consultant general surgeon at the hospital, said the region’s growth means many hospital facilities are often overstretched.

An ageing population means patients frequently present with complex medical problems.

“I think the population has outgrown the hospital considerably,” she said.

“The actual space that we do have works for its purpose; the trouble is that there are just more patients than we have space for.

“In the ED, in the theatres, in the clinics, and of course on the wards we are always pressed to fit everyone in.”

French said a business case has been submitted for an expansion of the endoscopy and theatre spaces to allow for more efficient throughput, fit-for-purpose facilities, and an improved ability to meet local and regional needs.

Increasing patient numbers, especially older patients, means an increased workload for everyone, from GPs through to rest homes, she said.

“You can feel it any time, there’s a stress on the system, because the backlog builds up, or spills over to the ED or hospital.”

French said staffing shortages combined with infrastructure challenges mean the environment is challenging.

“We are carrying on as best we can, but fundamentally there needs to be real expansion of infrastructure, and retention and hiring of staff, to make our hospital what it could be.”

McCann noted that annual hospital occupancy has remained relatively stable over the past few years, with seasonal fluctuations.

“We are mindful that capacity in Wairarapa is a system-wide challenge and that our hospital provides only one part of the overall patients’ care needs,” he said.

“Our annual hospital occupancy has remained between 60-70 per cent and ED presentations have also remained broadly similar in the past three years.

“The usual seasonal pressures will see these rates climb at peaks of winter activity and lessen off over summer months.”

McCann does acknowledge a steady rise in the hospital length of stay for both acute and planned patients, which “can be a result of not only the complexity of patients but the wider demands for care both inside and outside of a hospital setting”.

“Planning for hospital capacity needs to consider the availability of treatment and services in the community such as aged residential care and primary care,” McCann said.

Two senior doctors had recently been recruited, and “a further person, who is currently working through immigration processes, [is] due to start in January 2024. We also continue to engage with other potential applicants,” McCann said.

The occupancy and ED numbers provided by Te Whatu Ora have not yet undergone full quality assurance.

– NZLDR
Public Interest Journalism funded through NZ On Air