Health Minister Tony Ryall will set a maximum patient waiting time limit of 6 hours in hospital emergency department waiting rooms. This seems to me a fairly weak commitment considering that the UK set and met a commitment for a maximum waiting time of 4 hours. I rather suspect that Ryall is not keen to commit the resources needed to reduce waiting times.
- Reducing the number of minor complaints that present to the ED. This is simply not going to happen while after-hours GP care is expensive and ED care is free. Until the differential between after-hours care and ED care is reduced, people will sit and wait – and complain.
- Increasing ED staffing levels. There will be no reduction in waiting times while the emergency departments remain hopelessly understaffed. The dumb thing is that for 10 years we have had well-researched guidelines for optimal staffing levels in the ED – 1 doctor per patient per hour and 1 Nurse FTE per 1000 annual patient throughput. There isn’t a single ED in the country with staffing levels even approaching that.
- More Ward beds. Patients are hanging around in EDs waiting for surgery because there are insufficient ward beds. I have already argued that some of this is due to poor discharge processes. However there has been a very foolish tendency to reduce hospital size when rebuilding and no attempt has been made to increase bed numbers despite the increase in population. This happen in both National and Labour governments, so I am not expecting much change with change of government.
- More theatres, and theatre staff – including surgeons. There is still substantial delay in people getting their urgent surgery (let alone elective surgery). This is the only area of the four I have mentioned where National shows any commitment to resolve the resource issues.
The original triage system set the target for Category 5 (the least urgent) patients as “90% will be seen within two hours”. None of the large emergency departments have ever reached that target and most are falling further away from that every day. Six hours, to me, seems very under-ambitious.
DPF also blogs on this over at Kiwiblog. Interesting combination of astute observations and complete cluelessness in the comments. I’ll leave you to decide which is which