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‘Significant clinical risk’: Dargaville Hospital had overnight doctor only five out of 55 nights

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A senior Northland doctor was so worried about a lack of medical staff in Dargaville overnight she was convinced it was too risky to keep the town’s hospital open, documents released under the Official Information Act reveal.

A staff roster, also released under the OIA, shows that from 10 October to 1 December last year, an after-hours doctor was rostered on at the 12-bed hospital on just five of those 55 nights.

Two nights were marked as ‘tentative’ so the total could have been as low as three nights out of 55.

While the documents do not cover the period after 1 December, RNZ understands there has been no significant change in staffing since then.

In a letter to Northland’s top health official dated 30 September, Te Tai Tokerau chief medical officer Jennifer Walker said Ministry of Health rules stated rural hospital emergency departments should have an on-site doctor available within 10 minutes at all times.

While there was no clear rule on inpatient wards, she believed the same criteria should apply.

Walker said the lack of an overnight doctor represented a “significant clinical risk” that could not be fully managed by sending the sickest patients to Whangārei Hospital, or by providing on-line support to nurses on duty overnight.

While doctor shortages are common across rural New Zealand, staffing levels at Dargaville Hospital reached a crisis point in October last year.

Senior doctors have previously told RNZ the problems were exacerbated when Health NZ cut pay rates for locums, or short-term doctors.

Health NZ Te Tai Tokerau operations manager Alex Pimm raised the alarm on 9 September with a report warning there would be no doctors on duty overnight after 6 October.

All efforts to recruit medical staff – including locums and nurse practitioners – had failed, prompting him to propose closing the inpatient ward due to the “lack of sustainable medical workforce” and “inherent clinical and patient safety and reputational risk”.

That would have downgraded Dargaville Hospital to an outpatient clinic with daytime-only urgent care.

Pimm said risks of keeping the ward open included patients deteriorating overnight and needing medical help that wasn’t available; nurses feeling unsupported; patient harm due to understaffing; and more strikes by staff worried about health and safety.

The proposal was effectively vetoed by Health NZ at a national level.

In an email on 3 October, Walker expressed her surprise at the decision and reiterated her “very significant concerns about clinical safety for inpatients at Dargaville Hospital … when we have no access to an on-site doctor”.

She said Bay of Islands Hospital also had “quite a few vacant shifts” in October.

“It is my belief that I have clearly expressed my concern for clinical safety and this has not been accepted … I am worried regarding the potential consequences for patients and our staff,” Walker said.

On October 8, Pimm sent an email to staff, later leaked to RNZ, detailing how the hospital would function with no doctor overnight.

That included the use of telehealth, a low threshold for transferring patients to Whangārei, and making sure any patients staying overnight were stable and unlikely to need treatment.

Asked for an update on the current situation, Pimm said Health NZ was still recruiting to fill medical positions, including vacancies at Dargaville Hospital.

The organisation was also looking at how it addressed long-standing workforce challenges to make sure community needs were prioritised.

“The inpatient ward at Dargaville Hospital remains operating up to our 12-bed capacity. Our focus remains on ensuring that there is medical cover during daytime shifts when the rest of the multi-disciplinary team is present and most patient admissions and transfers occur,” Pimm said.

“Our priority remains on patient safety and wellbeing. While we recruit to vacancies and review our service model, we have changed some of the admission criteria to further minimise the risk of a patient requiring out-of-hours medical input as well as providing additional education to our nursing kaimahi. When there’s no doctor available, including overnight, we have a robust contingency plan in place to maintain patient safety.”

Pimm said Health NZ was reviewing how it would “continue to support the Kaipara community in a sustainable and safe way” and would seek feedback on its plans later this year.

The Association of Salaried Medical Specialists, which represents hospital doctors, and the nurses’ union NZNO have been approached for comment.

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Police say person who fired gun at officers still at large

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Police say a person who fired a gun at officers in Napier is still at large.

Eastern District Commander Superintendent Joel Lamb said Police tried to stop a vehicle in the Pirimai Area at about 10pm on Tuesday.

He said someone in the back seat pointed what was presumed to be a firearm at officers pursuing the vehicle.

“Staff have then heard two distinct gunshots as the firearm was discharged.

“Fortunately, neither of our officers were injured, and the patrol vehicle did not sustain any damage.”

He said hours later, the vehicle was seen travelling north on the Waikato Expressway towards Auckland.

Police seized the vehicle at an address in Manurewa, but they had not found the alleged offender.

Lamb said people who lived at the Manurewa address were engaging with Police.

He said Eastern District and Counties Manukau Police were making enquiries.

“Presenting a firearm at a Police officer is a serious escalation that puts our staff and the wider community at risk. This behaviour is entirely unacceptable.

“We are taking this incident extremely seriously and will be pursuing all lines of enquiry to locate the offender and hold them accountable.”

Police asked anyone who witnessed the incident to contact Police on 105 or online using the reference number 261111/3764.

Information could also be provided anonymously via Crime Stoppers on 0800 555 111.

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New Zealand sides named for RLWC finals

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The players tasked with ending Australia’s Rugby League World Cup dominance have been named.

The Kiwis and Kiwi Ferns have announced their squads for this Sunday’s World Cup finals in Brisbane.

Both sides are chasing their first titles since 2008, and both are looking to end their opponents run of three crowns in a row.

“Our Kiwi Ferns have been so dominant in years gone by, and we want to bring dominance back to this jersey, so I think it will be a case of who wants it more,” said co-captain Georgia Hale of the impending clash.

The Kiwis get a major boost for the final as they welcome back Ronaldo Mulitalo after he served a one-match ban for a high tackle against Fiji Bati.

Mulitalo replaces Charnze Nicoll-Klokstad, who moves to the six-man bench, which again includes utility Te Maire Martin, middle forwards Naufahu Whyte, Erin Clark and Xavier Willison plus fullback Keano Kini.

Loose forward Joseph Tapine will make his 30th Test appearance in a familiar pack again, including second-rowers Isaiah Papali’i and Briton Nikora, and props James Fisher-Harris and Moses Leota.

Winger Jamayne Isaako is on the cusp of claiming the New Zealand record for most Test points.

His five goals against Tonga lifted his career points tally to 225 – level with Shaun Johnson – while centre Casey McLean goes into the final with 16 tries in just eight Tests.

Fisher-Harris will again captain the team.

Fullback Ponga said the goal of the group was clear.

“We have high expectations around what we want to achieve, and obviously winning a world Cup is one of them.”

Meanwhile, Ricky Henry has selected a settled side to take on the Jillaroos, led by their lethal centre combination of Stacey Waaka and Mele Hufanga.

Veteran Apii Nicholls takes the number one jersey, Leianne Tufuga and Mackenzie Wiki on the wings.

Henry has stuck with his halves pairing of Chantay Kiria-Ratu and Raecene McGregor with Alexis Tauaneai, Georgia Hale and Otesa Pule up front.

Rounding out the starting pack is Shaniece Monschau, Kaiyah Atai, and Angelina Teakaraanga-Katoa.

“We have been building well throughout the tournament; we understand the Jillaroos side, and will give it our all to make New Zealand proud this weekend,” said Henry.

RLWC Finals:

Kiwi Ferns vs Jillaroos- 6.10pm

Kiwis vs Kangaroos – 9.35pm

Sunday November 15

Suncorp Stadium, Brisbane

Live blog updates on RNZ

Kiwi Ferns:

1. Apii Nicholls 2. Leianne Tufuga 3. Mele Hufanga 4. Stacey Waaka 5. Mackenzie Wiki 6. Chantay Kiria-Ratu 7. Raecene McGregor 8. Alexis Tauaneai 9. Georgia Hale 10. Otesa Pule 11. Shaniece Monschau 12. Kaiyah Atai 13. Angelina Teakaraanga-Katoa.

Interchange: 14. Ashleigh Quinlan 15. Annessa Biddle 16. Shannon Mato 17. Ivana Lauitiiti.

Reserves: 18. Brooke Anderson 19. Zahara Temara 20. Brianna Clark 21. Abigail Roache 22. Tenika Willison.

Kiwis:

1. Kalyn Ponga, 2. Jamayne Isaako, 3. Dane Gagai, 4. Casey McLean, 5. Ronaldo Mulitalo, 6. Kodi Nikorima, 7. Jahrome Hughes, 8. James Fisher-Harris (c), 9. Jeremy Marshall-King, 10. Moses Leota, 11. Isaiah Papali’i, 12. Briton Nikora, 13. Joseph Tapine (v/c).

Interchange: 14. Te Maire Martin, 15. Naufahu Whyte, 16. Erin Clark, 17. Xavier Willison.

Reserves: 18. Keano Kini, 19. Phoenix Crossland, 20. Charnze Nicoll-Klokstad, 21. Scott Sorensen, 22. Leo Thompson.

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Parliamentary Service working on extra chairs and offices for increased number of MPs

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The chief executive of the Parliamentary Service is confident there will be enough room to accommodate the increased number of MPs and their staff coming into Parliament.

On current numbers, up to 131 MPs could be sitting in the Chamber following the election, brought on by a record overhang result.

Clerk of the House of Representatives Dr David Wilson told the Spinoff that currently the debating chamber had enough chairs to seat 124 MPs – including the Speaker of the House – and work was being done to accommodate more by altering the seating arrangement.

In a statement, Parliamentary Service chief executive Rafael Gonzalez-Montero said planning for a larger Parliament had been going for “some time”.

“Now that the election results have confirmed an increase to the number of members we are looking at several options.

“We are confident we will be able to accommodate all members within the Chamber.”

Chief Executive of the Parliamentary Service Rafael Gonzalez-Montero appears before select committee.
Parliamentary Service chief executive Rafael Gonzalez-Montero.

VNP / Phil Smith

Gonzalez-Montero said office accommodation for members and their staff would be “stretched” for a short time, but the new Members’ Building was only a few months away from “practical completion”.

That building – located behind Parliament – was due to be ready to occupy in April next year and had capacity to accommodate around 30 backbench MPs.

“All members should be in fit-for-purpose accommodation from that point,” Gonzalez-Montero said.

Following the 2023 election, 123 MPs sat in the Chamber – a record number at the time. That decreased to 122 following the resignation of National MP Judith Collins.

Collins held the seat of Papakura and stepped down in May and Parliament voted against holding a by-election because it was too close to the election.

The election result also meant high-ranking National Party MPs like Chris Bishop, Paul Goldsmith, Nicola Willis and Gerry Brownlee – Speaker of the House and an MP for 30 years – would likely not make it back into Parliament.

Only resigning or retiring MPs were permitted to give a valedictory speech meaning none of them would get the chance to give a valedictory statement.

Asked if their would be special allowances for valedictories, Wilson said in a statement that normally only MPs were allowed to speak in the House but the House could suspend its own rules or temporarily alter them.

“It could do so to allow former members to address the House.”

Wilson said no such arrangements could be made until the next Parliament opened and members sworn in.

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