Dannevirke’s small community hospital does not have enough clinical staff to care safely for the patients it admits, an urgent Health New Zealand audit has found, and the Tararua Health Group now has 30 days to fix its rosters and recruit more doctors and nurses.
The findings, reported by RNZ on Monday 28 September, back up concerns raised by local doctors who had stopped referring patients to the hospital because of safety risks. Health New Zealand had already frozen new admissions to the six-bed hospital last Thursday while it sent in its own staff.
Geoff Gwyn, Health New Zealand’s central region director, said the concerns were correct. “[The audit] shows that they are not capable at the moment of providing a safe and sustainable inpatient service,” he told RNZ.
“They don’t have sufficient clinicians to actually deliver what we would consider a roster that is safe for patients who are admitted to the hospital.”
Five clinicians from Health New Zealand have been sent to Dannevirke to bolster staffing. Gwyn said the situation had gone downhill since a routine audit in June, which found no critical problems but did record 23 low-to-medium level concerns.
He said the agency’s intervention carried contractual implications for the operator that he could not discuss because they were commercially sensitive. “No decision’s been made about the contract. What we want now is for Tararua Health Group to fix the problems and prove to us that they can provide safe and sustainable care.”
The hospital, along with several medical centres in the district, is run by the Tararua Health Group, which is owned by OmniHealth, a network of about 17 general practices around the country. Palmerston North Hospital is taking admissions while the freeze is in place.
Tararua Health Group director Mark Wills said the company was taking the audit very seriously. “Our priority right now is to ensure that the community hospital has the staffing levels and the clinical skill mix that we need to provide a safe and sustainable service,” he said.
Wills said the hospital had relied on a single doctor, supported by local GPs, but that doctor had recently resigned. He described the staffing gap as “not huge”, pointing to a need for 5.7 full-time equivalent nurses. “It’s not huge, but obviously it’s critical and we need to make sure that we close those gaps.”
He said the company was actively interviewing and recruiting, and had no intention of walking away. “This service has been in place for many, many years and we intend to continue it for many more.”
The freeze was first announced on Thursday 24 September. At the time Gwyn said new admissions would be paused for 30 days while Health New Zealand provided “additional clinical workforce support”, the Otago Daily Times reported. Patients already in the hospital would continue to be cared for and maternity services would carry on as normal.
The same day, Malcolm Mulholland of the advocacy group Patient Voice Aotearoa said he was baffled by the decision. “It effectively becomes a patient-less hospital, I’ve never heard of one of those,” he told RNZ. He said the Tararua Health Group should not keep the contract to run the hospital.
That evening about 200 people turned out to a public meeting in Dannevirke, one of three community meetings held on local health services. Gwyn told the crowd there were no plans to close the hospital, and explained that the unannounced audit had been carried out on Tuesday 22 September after he listened to the community and to clinicians.
Some at the meeting blamed a change in culture under corporate ownership. Retired sonographer Annie Poulton, who worked for the Tararua Health Group for 23 and a half years, told RNZ that staff morale had declined while OmniHealth was the majority shareholder and that many experienced people had left. She said she would like to see the hospital become a community-run entity rather than one led by a corporate.
Tania Chamberlain, who oversees a local iwi-run GP clinic and formerly worked for OmniHealth, said clinicians had been so worried about the hospital that they were sending elderly patients to hospital emergency departments instead, where the wait could stretch to 27 hours.
Tararua District mayor Scott Gilmore said the turnout showed how much healthcare mattered to rural people. “Rural healthcare absolutely is difficult, but that doesn’t mean we should accept not having a good safe service for people living in our areas.”
The Dannevirke problems follow trouble at another Tararua Health Group practice down the road. Six staff at Pahiatua Medical Centre, which almost 5000 patients depend on, resigned earlier this month citing extreme workloads and patient safety, as Newswire reported. Health New Zealand also reviewed that clinic.
Gwyn said the Pahiatua review was complete and would be shared with staff on Wednesday. Since then the primary health organisation had installed a full-time GP and a practice manager for three months, nurse practitioner support was on the way, and all overdue patient recalls had been reviewed and actioned. He said he hoped the staff who had resigned would work through the findings and decide to stay.
The Tararua story is a familiar one in provincial New Zealand. Small rural hospitals and practices often depend on one or two doctors, so a single resignation can tip a service from fragile to unsafe almost overnight. Mayor Gilmore made the same point, saying rural health services also need to be great places to work if they are to attract and keep doctors and nurses.
For now the clock is running. Tararua Health Group has until late October to show Health New Zealand it can staff the hospital safely. If it cannot, the future of the contract to run Dannevirke’s hospital will be back on the table, even though Health New Zealand has said closing the hospital itself is not on the cards.
Do you live in Tararua or rely on a small rural hospital? How has access to care changed where you are? Share your experience in the comments below.
This article was written by AI, briefed to report the facts, hopefully without some of the bias people bring to the job 🙂
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