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The hospital was briefly crammed beyond capacity on March 24, with patients queuing in corridors awaiting a bed.
Mr Fleming declared a Code Black situation and an operations centre was opened. Several hours later the crisis was resolved.
The recriminations have rumbled on for much longer though: Health Minister Andrew Little singled out the Southern District Health Board for criticism for letting the hospital get into such a quandary.
In an email to all staff, which was supplied to the Otago Daily Times, Mr Fleming said he wanted to speak to staff directly about the media coverage of the Code Black incident.
"I appreciate that the media attention has created undue stress for some of you: please do not take the criticism directly on yourself," Mr Fleming wrote.
"We all (management and clinicians alike) had a role to play in the fact that the hospital got to the stage it did that day, and we all need to take respective roles in ensuring actions are taken early when these situations start to arise again in the future.
"The system failed to respond to the building pressure, and as such we must accept collective responsibility for this."
A doctor, speaking anonymously, said Mr Fleming was blaming clinicians, who had repeatedly warned a problem was looming.
"Clinicians are outraged," the doctor said.
Mr Fleming’s email went on to praise staff for their response on March 23, saying many people put in a "huge effort" to attempt to manage the situation.
"However the statement [by Mr Little] ‘very poor management, very poor patient planning’ must be seen in the light of our collective failure, both managerially and clinically, to recognise the increasing pressure and take effective steps to remediate the problems before they reached the extent we found that day," Mr Fleming’s email said.
Mr Fleming said he was confident that "as a collective organisation" everyone had stepped up their game, that everyone had learned from the Code Black experience, and that the SDHB was in a better position to manage ongoing pressure at Dunedin Hospital.
Sarah Dalton, executive director of senior doctors union the Association of Salaried Medical Specialists, said Southern doctors were frustrated by the assertion that the Code Black issue was of everyone’s making.
"At the heart of the issue, other than the not-fit-for-purpose building that everyone is trying to navigate, is short staffing, and that’s not just
medical but nursing as well.
"I can see why a group of doctors could be peeved by
that ‘we’re in this together, we’re all failing a bit’ language, it’s very galling for frontline clinicians who are doing their best."
The ASMS understood that for several weeks leading up to the Code Black incident, Dunedin Hospital emergency department had substantially failed to meet its target of 95% of patients seen within six hours.
That measure, which many DHBs regularly fail to meet, had gone as low as 59% on one day, Ms Dalton said.
"It was mostly in the 60s and 70s, so it is normal for them to fall well short of target, for a whole bunch of reasons."