A critical shortage of senior doctors at Whakatāne Hospital’s Emergency Department (ED) is placing immense pressure on staff and threatening the continuity of essential services –particularly overnight care.

The long-developing crisis has reached a point where the overnight closure of the ED is being discussed by some staff as a contingency if critical staffing gaps cannot be filled.

Health NZ’s regional director, Cath Cronin, has acknowledged the strain but says closure of the ED is not part of the escalation plan and they have several strategies in place to ensure it remains open.

Recruitment was under way across multiple departments, including ED, she said.

“We have robust escalation planning in place,” she said. “ED is expected to return to full staffing levels by November.”

Ms Cronin said staffing challenges were common in rural and regional hospitals, but Health NZ was working to ensure safe, timely and high-quality care.

Several doctors told the Beacon ED was operating with dangerously low staffing levels, risking patient safety and staff wellbeing. The Association of Salaried Medical Specialists union is aware of the issue and working to address it.

“We are critically short-staffed, particularly of doctors,” said senior emergency physician Dr Kate Anson. “The community has a right to know how critical the situation has become – this is primarily a patient safety issue.”

Dr Sophie Parnham, another senior ED doctor, said the situation had steadily worsened.

“Every winter we are understaffed, but this year has been the worst. There are frequently uncovered shifts, and we often don’t know who will fill them until the last minute. I live in fear that one day, I’ll be handing over a shift at night and there will be no one there to take over.”

Doctors emphasise they do not want the ED to shut overnight, but say a plan is necessary in case it happens. “It would be a massive risk, especially for rural patients,” said Dr Anson.

Patient numbers have surged, from 24,700 in 2022 to 31,000 this past year, and doctors say the acuity of patients is also increasing. Wait times of six to nine hours are now common for those with less urgent conditions.

Patient Maurice Webster shared his experience: “I arrived at 11am and waited in a bed until 3pm. A nurse told me no doctors were available, so I left.”

Doctors are deeply concerned.

“We are seeing very long waits,” said Dr Parnham. “Even fully staffed, ED is a tough environment. With current shortages, it’s a daily struggle just to deliver basic care.”

The ED needs around 14 full-time equivalent (FTE) senior doctors to operate safely 24/7. It’s currently short by an estimated 7.5 FTEs, although this has been difficult to confirm.

Dr Kathryn Duffy, who joined over five years ago, said the department had been fully staffed for only about six months in that time.

She blames recruitment delays on bureaucracy and budget constraints.

“It feels like a lot of additional bureaucracy ...and as if we can’t talk to the people who can make decisions, and even if we do get the right people in the room, there is no budget.”

One senior doctor, who declined to be named, said working full-time had become so intolerable that they had to switch to part-time for their own wellbeing.

“But I don’t think there is any week that I actually work part-time.

“We’re so under the gun that even basic care is a challenge,” the doctor said, adding that although the staff were dedicated, skilled and highly trained, they felt “the system is falling apart around us.”

The doctor questioned whether underfunding might be deliberate, to push people toward private healthcare.

“If you defund and understaff a public system, you wear out physicians and the community will be at risk of substandard care.”

Ms Cronin said escalation planning was standard in hospital operations.  

"It  allows us to respond in a calm and methodical way to prioritise care for our most unwell patients while maintaining service continuity.

"Closure of the ED is not part of our escalation planning and we have several strategies in place to ensure it remains open and operational."

East Coast MP Dana Kirkpatrick confirmed she had been contacted by hospital staff. “Health NZ has assured me they’ve met with ED staff and are committed to keeping the ED open and functioning,” she said.

“It’s critical that ED and afterhours care are available – especially since specialist maternity services still going to Tauranga.”

For doctors on the front lines, the crisis is more than logistical – it is emotional and mental.

“I come home after evening shifts and I am awake for hours, going over every patient I have seen,” said Dr Duffy. “The cognitive burden is so high at the moment.”

“It is absolutely exhausting. A lot of doctors are approaching burnout,” said Dr Parnham. “Almost every day we are being asked to do extra shifts.”

Despite the crisis, some positive changes are emerging. Doctors praised the appointment of interim manager Jenny Martelli. “She’s a huge support and a real asset to the hospital,” said Dr Parnham.

Doctors stressed that people should not avoid ED despite the delays.

“Our community is one of the joys of working here,” said Dr Duffy. “People are patient and understanding. But they deserve to know what’s happening.

“We need to be asking for an excellent standard of healthcare. We need to focus on retaining and recruiting specialists.”