Having learned from last year’s lockdown, healthcare providers kept less urgent treatment on the books during the latest outbreak. Even so, 20,000 people have been waiting for elective treatments for over four months.
The first cohort of health and disability workers given priority access to MIQ begin arriving next Monday – but despite the Government’s opening up of MIQ to badly needed health workers, opposing voices are raising questions about whether this response will be quick and comprehensive enough to prevent healthcare logjams.
The first 33 workers have been granted space in MIQ, and will arrive over the course of next week in the realisation of a plan first announced by Minister for Health Andrew almost a month ago. The plan was in recognition of the critical need for health workers to help carry the weight of the pandemic.
“Whether it’s bringing doctors or nurses in from other places or New Zealanders bringing their skills home, we need to be able to get them into the country and into the workforce,” Little said.
The move is hoped to help the healthcare system work its way more quickly through waiting lists that have grown since the beginning of the pandemic.
The lockdown at the beginning of 2020 and the latest Delta outbreak have both significantly affected delivery of treatments, despite DHBs being encouraged to continue to deliver as many planned care services as possible, where patient and staff safety could be maintained.
According to figures from the Ministry of Health, 6700 inpatient elective procedures have been postponed across the country since August of this year – with about 3500 of these in Northland and Auckland.
By September, planned care inpatient procedures in this northern region had returned to around 50 percent of the usual volume, while DHBs south of the Auckland borders had mainly returned to 80 to 100 percent of normal delivery.
But although the ability to get people through their elective procedures picked up as Auckland made it to Level 3, waiting lists are still affected by the unserved demand of August.
The Ministry of Health reported 19,765 patients who had been waiting for longer than four months for treatment as of September of 2021 – compared to 14,225 in July.
This suggests a bump of several thousand people waiting to be treated after the country went back into lockdown.
And that number may soon grow further – studies from other parts of the world have shown these wait lists are liable to lengthen at accelerating rates once a country gets out of lockdown.
A study out of Finland comparing rates and waiting times for elective surgery from 2017 to 2020 found the reorganisation of the healthcare system due to the pandemic increased wait times by as much as a third.
They also found while the rates of people going for elective surgery dropped during the early months of the pandemic, demand increased by as much as a fifth once the country came out of lockdown.
A spokesperson from the Ministry of Health said the ministry acknowledged the issue, and DHBs were currently addressing it in a number of ways.
“DHBs have signalled that in the current environment it will be challenging to recover planned care waiting lists,” the spokesperson said. “However, the ministry is working with DHBs to identify services where various gains can be made as the current Covid-19 alert levels diminish.”
Some of the measures DHBs are putting in place include prioritising urgent and non-deferrable cases, outsourcing, running additional surgical lists and extending the use of community providers.
And on top of that are the 300 MIQ allocations put aside for health and disability workers, which the ministry characterised as part of rebuilding the health sector.
But this response from the Government is coming five months too late, according to National’s immigration spokesperson Erica Stanford and Covid response spokesperson Chris Bishop.
Stanford alleged in written questions back in June that Little had acknowledged critical health workers were having trouble getting into New Zealand via MIQ.
“Somehow, he still dithered for five full months before announcing MIQ spots would be allocated to critical health workers,” Stanford said.
Bishop said if the allocations had come into effect five months ago, New Zealand would currently have 1200 more critical health workers to cope with issues of ICU capacity and lengthening waiting lists.
Meanwhile, the New Zealand Nurses Organisation (NZNO) is concerned a staffing crunch at Auckland hospitals puts patient care at risk.
“The strain on Auckland health care workers right now is enormous. Each of the three Auckland DHBs has 300-400 nursing vacancies at present and, on top of this, members say a lot of staff are taking sick leave which puts even more pressure on those remaining at work,” said NZNO lead organiser Christina Couling. “Auckland hospitals may be at less than 100 percent bed capacity, but in many cases there are not enough staff to provide the care required for patients who are seriously unwell with quite complex needs.”
The extra nurses may be on the way, but it isn’t as simple as them showing up to work next week.
“These workers won’t even be able to start arriving until the end of November, only to then spend two weeks in quarantine,” Bishop said. “For those nurses that also need to complete their pre-registration course, it won’t be until March 2022 until they can even begin work.”
The new priority allocation will allow 300 health workers through the MIQ system a month – although this month, only 33 will come through.
The Ministry of Health reported 79 applications were made before November 5 – the close-out date for this cohort. Of these, four were ineligible as they were workers currently based in New Zealand who were looking to leave and come back for personal reasons.
The remaining 42 people were either asked to provide additional information, or were planning to arrive after November 30 – in which case they will be processed as part of a later cohort.
But with over 1000 nursing vacancies in Auckland alone and steadily climbing Covid case numbers, a slow trickle of critical health workers getting off the plane may not be enough to solve the problem in time.