We learned this week Dunedin Hospital had the worst ED wait times in the country on three of seven days last month with only 35.9% to 48.4%, meeting the target time of being processed within six hours.
Those sharing their ED stories with us are not people who have minor ailments which might be better treated elsewhere.
They are people who needed to be in the ED and were right to expect to be seen promptly.
While they may be understanding of the pressure staff are under, and appreciate the care they eventually received, they feel the system let them down.
The fact that on some days waiting times will be shorter than those we have mentioned is no comfort to those who have endured an excruciating wait.
Regular readers of this newspaper will be used to seeing articles about long waits in Dunedin Hospital’s emergency department.
Basically, they all tell the same story.
There are too many people turning up for the facilities and staff available, and as the number of extremely sick complex patients arriving increases with our ageing population, they take longer to assess and, because there are limited staffed beds, they cannot be moved into wards quickly if that is what is required.
It is also not always easy to quickly discharge patients to suitable places once they have been treated either.
Over the years, considerable time and money have been spent on a variety of projects to address the flow of patients through the ED.
Some improvement has occurred occasionally, but here we are in 2025, retelling the story from decades ago.
The current government has decided the way to solve this problem is by reinstating the six-hour target time for ED visits, something originally introduced by National’s health minister Tony Ryall in 2008.
The need to manage the potential for gaming and unintended consequences of the health targets was outlined in a confidential briefing to former health minister Shane Reti last year, but we are not sure there has been reporting on how well developed the measures to address this are.
When he announced the health targets last year, Dr Reti described shorter stays in ED as a "snapshot of how the whole health system is coping as the interface between community and hospital care".
He said the government would be working hard at keeping people out of the EDs and avoiding bed block when they need to be admitted to hospital,
That might have been the hope, but it is hard to see much evidence of it working yet.
Spreading the load of urgent care by putting money into better after-hours services outside public hospitals may not attract those patients who are turning up to ED because they cannot afford to see a general practitioner or cannot readily get to see one.
Some Auckland hospitals offer vouchers to some patients so they can be treated for free at private urgent medical centres to take pressure off the hospitals, but we are not sure how widespread this practice is and whether it is planned here.
When announcing the targets, Dr Reti acknowledged the health workforce would be key to achieving them and building it remained a priority.
But more than a year on there are concerns being raised about hiring freezes in a variety of areas.
The government wants to convince us it has already solved the shortage of hospital nurses, the largest section of our health workforce.
Nurses, striking again today, tell a different story.
Providing better care in both hospitals and the community involves having enough staff, and staff who are happy with their pay and conditions.
We are a long way off that.
Health Minister Simeon Brown saying he expects Health New Zealand Te Whatu Ora to lift its performance on the ED targets does nothing to explain how that will be achieved.
