New Zealand’s emergency departments are now handling more than 1.4 million visits a year, a record, and two in every three patients arrive sick enough to be triaged as high urgency, according to the first New Zealand “State of Emergency” report from the Australasian College for Emergency Medicine, reported by RNZ on Wednesday.
The report landed on the same day nurses at one of Auckland’s busiest emergency departments claimed a win. Health New Zealand has agreed to employ 24 extra nurses in the North Shore Hospital emergency department after a winter staff described as a nightmare, RNZ reported.
The college’s figures show emergency department visits have risen 21 percent since 2015-16, while the population grew 13 percent over the same stretch. Demand is not just rising, it is getting heavier. In 2024-25, 66 percent of presentations were triaged in categories one to three on the Australasian Triage Scale, the most urgent end of the range, up from 55 percent in 2015-16. Visits by Māori patients rose 39 percent over the period, almost double the overall growth rate.
The report’s data on beds points to where the squeeze sits. Between 2015 and 2024, inpatient bed supply fell from 2.7 to 2.5 beds per 1000 people. The absolute number of beds went up, but not fast enough to keep pace with a growing and ageing population. The OECD average in 2023 was 4.2 beds per 1000 people. When there is no ward bed to go to, patients stay in the emergency department, and the next arrival waits in a corridor.
Dr Michael Connelly, who chairs the college’s New Zealand council, called the report a reality check and a call to action. “Rising presentations, more complexity, and loss of capacity is being felt everywhere,” he told RNZ. “Privacy is at a premium, with patients being cared for in corridors and ambulance bays within a metre or two of a complete stranger also needing high-level care.”
Connelly said treating patients in corridors had become an everyday occurrence, and that patient care was at risk, particularly when people were stuck in the department for more than eight hours because no bed was free upstairs. “You push a system to a breaking point and then things start to fail,” he said.
The report sets out three priorities, patient access and flow, the workforce, and health equity for Māori. It calls for more beds, better movement of patients through hospitals, better buildings, and more investment in training and keeping emergency doctors, including in rural areas.
It is not all bleak. The college notes health funding has almost doubled since 2017-18, though it adds that “nominal figures alone do not show whether funding has kept pace with demand”. New specialists made up 7.4 percent of the emergency specialist workforce in 2025, and the workforce grew about six percent overall.
Wait times still depend heavily on where you live. In the latest government target figures, covering March to June 2026, half of the country’s emergency departments improved on the previous quarter and half went backwards. Palmerston North Hospital had the longest waits, with just 55 percent of patients through the department within six hours. Capital and Coast was second to last at 63 percent, though that was an improvement. The West Coast, South Canterbury and Tairāwhiti (the Gisborne district) did best, with 90 percent seen within six hours.
Health Minister Simeon Brown argued the picture has improved since the report’s data ends. “Reducing the time patients spend in ED is one of the Government’s health targets, and results since June 2025, where the report’s data ends, show we’re making progress,” he said. According to Brown, nearly 9000 more people were seen within six hours nationwide than at the same time last year.
Brown acknowledged the long-running bed shortfall. “For many years, under successive governments, hospital capacity hasn’t kept pace with a growing and ageing population,” he said. He pointed to 140 new beds in fast-built wards at five of the busiest hospitals, more than $680 million of health capital investment in Budget 2026, about $79 million more for aged residential care, and moves to extend urgent care so fewer people need an emergency department at all.
At North Shore Hospital, the fix has been people rather than beds. Nurses went public in August about a department that sometimes held triple the number of patients it was staffed for, saying patients were being left in soiled beds and they feared they could not care for them safely. Health New Zealand began recruiting nine nurses soon after, and on Tuesday said it would hire another 15.
Jean Classey, an emergency nurse and Nurses’ Organisation delegate, said staff were elated. “I don’t think we would have achieved this if we hadn’t stood up and spoken out. They would have left us languishing – so for us it is an absolutely amazing victory,” she told RNZ. More nurses on every part of the floor would make it harder to miss a patient deteriorating fast, she said.
Hospital head Brad Healey admitted the winter had outrun the planning. “They’ve been under enormous pressure. Much more pressure than we expected when we were doing our winter planning. The volumes coming through has been very challenging,” he said. In a letter to staff seen by RNZ he wrote, “Your concerns have been heard and taken seriously.” Recruitment is already under way, and Waitakere Hospital, which also struggled this winter, is to get 15 nurses.
Healey said lessons would carry into planning for next winter. “With hindsight, I think we would all say it would have been better to have had additional resource in place but we just didn’t know.”
The new North Shore roles are part of 380 nursing positions Health New Zealand announced nationwide last week after its annual staffing calculation, following a two-year hiring slowdown aimed at saving money. Classey said there was still a long way to go to stop patients being treated in corridors or stranded in the department waiting for a bed, and hoped nurses elsewhere would keep pushing. “Because we know across New Zealand there are shortages in every other bit of healthcare,” she said.
The two stories point the same way. Extra nurses ease the crush inside the emergency department, but the college’s numbers say the longer answer lies upstairs, in having enough ward beds for patients to move into.
Have you or someone close to you spent a long night in an emergency department this winter? Tell us what it was like 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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