Doctors warning of crisis at Gisborne Hospital say it is demoralising to reach out for help, only to be told there is no crisis.
A group of more than 30 Tairawhiti doctors wrote to the government last month, saying some hospital services were on the brink of collapse and about 40% of senior positions were vacant.
Health Minister Simeon Brown wrote back to the doctors this week, saying senior medical staff had been hired, accepted offers or were in the stages of recruitment.
Alex Raines, a senior doctor speaking on behalf of 30 doctors at Gisborne Hospital, said the minister's letter was not reassuring and was similar to a response they received last year.
"Basically, to tell us that there is no crisis, that evidently we are not working with the kind of staffing we're talking about and that evidently things are moving in the right direction...
"If things were actually moving in the right direction, would we have reached out in the way that we did and tried to bring attention to this crisis?"
Raines said it was a mystery why the government's position was completely different to those with jobs on the frontline.
"It's funny, when the letter that we most recently wrote was reported publicly, the Minister responded, saying, 'Oh, there's been eight new doctors hired since August of last year'.
"We were a meeting of the senior doctors at the time, and we all looked at each other and said, 'Are you hiding doctors that we don't know about?'"
There seemed to be confusion between short term doctors, who were filling in gaps for a week to a few months at a time, versus long term permanent doctors they needed to staff their services, he said.
"In my department, which is one of the departments we warned is unfortunately on the on the brink of collapse, we have had an influx of short-term locums working again a few days at a time, maybe up to 2-3 weeks at a time. That will keep our service open for the next couple of months, but then what happens after that, right when those folks leave?
"Then who do we have to replace them?"
Raines said the hospital was constantly recruiting, as medium-term staff that worked there for 6-12 months needed to be replaced after they leave.
"We have been in this scenario perpetually, since I got here three years ago, and it's just gotten worse with time."
Being told things were moving in the right direction and the hospital must maintain momentum didn't match what was happening on the ground, he said.
"The reality is the folks who are leading this and should be addressing this aren't here. They don't see what we're dealing with on a day-to-day basis."
He said hiring doctors took time and most of the doctors recruited were from overseas.
"It's very difficult to recruit Kiwi doctors to remote hospitals like Gisborne. Obviously, Nelson has been in the news recently, as well, for similar challenges.
"It takes a very long time to go through just the recruiting process of applying and interviewing, and getting job offers, that part moves very slowly within our organisation."
Registration through the Medical Council also takes time, as well as going through LCC immigration, Raines said.
"Then there's just the logistics of moving sometimes an entire family to the other side of the world, like I did with my family."
He said they told doctors it took at least six months to get to New Zealand.
"With many of the doctors we have hired, and have signed job offers and are planning to come, many of them are not coming for even beyond 12 months, as far as their plan-to-start dates."
Raines often spent much of his week on recruiting and rostering.
"We are really limited as far as administrative staff to actually provide the support and carry out the recruiting services that need to be done, and it is just a time-consuming process."
He said their local hospital director had been working to get more administrative resources.
"Unfortunately, almost always those conversations start with 'in the absence of more money or resources'. The reality is that we are working from a scenario in which we have been told there is no additional budget for anything and that the budget cuts have actually impacted us significantly, even though they were sold as not affecting the frontline."
His department in general medicine may have to close for several days per week.
"We do have some additional folks coming in as short-term locums to help fill the gaps in the coming months," Raines said. "We have been waiting on some arrivals of medium-term doctors who are here for three months or six months or 12 months, and expect some arrivals in the coming months.
"Next month, we have full staff to cover our acute services, our inpatient wards, but that is just covering our acute services."
Raines and the 30 doctors that signed the letter still believed Gisborne Hospital was in a staffing crisis.
"Unfortunately, our planned care, our referrals from primary care, our follow-ups from post hospitalisation, many of the other services that our department provides are really quite limited right now, because we're really just down to a core few doctors."
Health NZ chief medical officer Professor Dame Helen Stokes-Lampard agreed Gisborne Hospital struggled to recruit permanent staff members, particularly senior doctors.
"Those that are there do a remarkable job, like Alex and his colleagues, in keeping the service going, while we are working hard to recruit more," she told Checkpoint. "Obviously, the intent and the need in the country is get more doctors from overseas, because we don't want to take doctors from one hospital to another - that just moves the problem around the country.
"The situation in Gisborne is difficult, but there is help on the way, as Alex has alluded to. What can be frustrating is the time it takes to get new doctors in.
"It is serious, really serious and we're taking it seriously."
