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‘Very significant concerns’: Documents reveal tension over proposal to close Dargaville Hospital

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Documents released under the Official Information Act reveal tensions between clinical staff, local managers and national health bosses over a proposal to close Dargaville Hospital due to a lack of doctors.

While staff shortages are common at rural hospitals around the country, the situation at Dargaville reached crisis level in October when no doctor could be found to work the overnight shifts.

A staff roster dated 1 October showed a doctor was available after-hours for just five of the 55 nights between 10 October and 1 December.

Health NZ, however, said doctors stepped up at the last minute to fill most of those roster gaps.

The alarm was raised on 9 September by Health NZ Te Tai Tokerau operations manager Alex Pimm, who warned no doctor would be on duty overnight from 6 October.

His report proposed closing the inpatient ward from that date, due to a “lack of sustainable medical workforce” and “inherent clinical and patient safety and reputational risk”.

Most staff could be redeployed to Whangārei and Bay of Islands hospitals but a small number would be required at Dargaville to run outpatient services.

Consultation would need to be fast, and “significant public and media interest” would have to be carefully managed.

Had the closure gone ahead, Dargaville Hospital would have been downgraded to an outpatient clinic with daytime-only urgent care.

The report caused an immediate kerfuffle, with a senior manager suggesting it should be pulled, or at least noted as a draft.

The report, released under the OIA, was watermarked: “Draft for discussion – Not government policy”.

A revised report, dated 19 September, spelled out the efforts made to recruit medical staff, and six options ranging from no change at one end of the scale to complete closure at the other.

The risks of the no-change option included patients deteriorating overnight and needing help that was not available; nurses feeling unsupported; patient harm; and more strikes by staff worried about health and safety.

The preferred option was to switch to an “enhanced urgent care model”, which would still mean closing the ward and moving overnight patients to Whangārei.

On 2 October, Pimm emailed Chris Lowry, a senior manager at Health NZ, again explaining the situation and recommending Dargaville stop admitting new patients overnight.

He also recommended the hospital “transition to not provide an inpatient service from 7 October” while continuing to provide urgent care and booked medical procedures during the day.

Lowry emailed Health NZ chief executive Margie Apa, saying he believed Pimm’s recommendations were appropriate.

In the same email, he revealed the problem had escalated in the previous 24 hours due to a senior doctor going on long-term sick leave.

Later that day, rumours of a possible closure started filtering into the public domain.

A reporter emailed then-Health Minister Shane Reti, who contacted senior executives at Health NZ.

Health NZ stated the rumours were wrong, closing Dargaville Hospital was not under consideration, and any suggestion otherwise was incorrect.

The following morning, Apa demanded assurance from Northland health managers that every avenue for maintaining overnight service had been explored.

“Please instruct the team that they must action every option to maintain overnight cover until we are able to put in place a timeframe with community to consult on changes if they are required,” she wrote.

Tensions rose in the emails that followed Apa’s apparent smackdown of the closure proposal.

Northland chief medical officer Jennifer Walker – who had previously issued a stark warning about the risk of keeping the hospital open – expressed her surprise and reiterated her “very significant concerns about clinical safety for inpatients at Dargaville Hospital … when we have no access to an on-site doctor”.

Responding to Apa’s email, Pimm wrote: “There seems to be some suggestion that we have not been trying hard to find cover and keep the ward safely running. I hope I am misinterpreting things but I want to be very clear that the team and I have worked very hard to find medical/nurse practitioner cover.

“I understand, Margie, that you were advised on 15 August of the likely need to close the ward … There comes a point where we have to recognise that we have reached the limit of our actions and need to make a decision.”

However, by 8 October, local managers appear to have accepted Health NZ’s decision to keep the hospital open, despite misgivings.

That day Pimm sent an email to staff, later leaked to RNZ, detailing how the hospital would function with no after-hours doctor.

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

In an update provided to RNZ last week, Pimm said Health NZ was continuing to look at how it addressed long-standing workforce challenges to ensure community needs were prioritised.

Health NZ was still working to fill vacancies at Dargaville Hospital, and reviewing how it could “continue to support the Kaipara community in a sustainable and safe way”.

Pimm said Health NZ would seek feedback on its plans later this year.

An interim plan designed to keep the hospital functioning safely, making use of an on-call doctor when available and a telehealth service on other nights, is due to come into force this Saturday.

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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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