Alarm bells ring … who’s responsible?

Two alarms were sounded in recent days on two entirely different and disturbing issues in Hawke’s Bay.

Both raise the question … who is actually responsible for the problem cited.

Healthy rivers

In the first instance, the HB Regional Council itself issued a media release headlined, New data shows long way to go for river health. It acknowledge the verdict of a damning national update on river health.

The release noted: “Hawke’s Bay Regional Council monitors over 90 river sites around the region, which shows us where work needs to be done to improve our waterways. The overall patterns are already well established, however, and show that the poorest river health is linked to higher levels of catchment modification and land use intensification.”

Many people will react to that with, “Well fix it, HBRC, what are you waiting for? Didn’t we just give you a gigantic rates increase?” And indeed the release further notes that, “There will be greater compliance monitoring of new freshwater regulations, and more funding to protect threatened regional biodiversity. We’re investing more than $40 million in this long term plan, alongside landowners, on work on the ground to improve water quality.”

So will the rivers get fixed?

1. Takes money. That box appears ticked.
2. Takes resolve. At least for the current and two past councils, that box appears ticked.
3. Takes appropriate regulatory requirements being in place. Definitely a box not ticked, although the Council has been striving to get the relevant rules in place for years now, stymied mainly – if Council leaders were to be candid on the matter – by its own Regional Planning Committee.
4. Takes behaviour change by polluters. Here, a mixed bag. Many act responsibly and respond to growing environmental expectations; others will hang onto existing degrading farming and industrial practices as long as they possibly can (so back to numbers 2 and 3).

So the verdict on this one? Upset about river quality? Focus on the perpetrators (#4) and the impeders (#3), not the caretakers.

Healthy people

About the same time, a complaint was filed against the Hawke’s Bay DHB on behalf of its Emergency Department nurses.

In this case, The New Zealand Nurses Organisation (NZNO) has supported staff working at the Hastings Hospital Emergency Department to issue a Provisional Improvement Notice (PIN) to Hawke’s Bay District Health Board (HBDHB) for failing in its primary duty of care under the Health and Safety at Work Act 2015.

In their media release, NZNO organiser Sue Wolland says issuing the PIN became necessary because repeated attempts to escalate concerns about dangerous working conditions that threaten patient safety have been ignored or minimised. “Staff are working under incredible pressure which is severely impacting their physical and mental health. The department is well beyond capacity every day which means staff are unable to respond to people needing emergency care in the time required to best ensure their wellbeing.”

Issues complained of include: “Patients being ‘housed’ in inappropriate or hazardous places such as corridors; dangerous delays in triage and assessment; seriously unsafe and inadequate staffing levels; nurses too overworked to take meal and other breaks; patients missing out on essential care; increased risk of error; and staff feeling unsafe and anxious while at work.”

Pretty disturbing, most readers would agree.

So why the PIN now?

“ED staff, including those in leadership, have repeatedly raised these concerns with the DHB and minor solutions have been proposed that never seem to eventuate. Our members have made these approaches in good faith, but sustained lack of progress has been the tipping point for issuing this PIN.”

The HBDHB responded with a statement noting a variety of factors affecting service delivery, from the respiratory syncytial virus (RSV) outbreak to Covid lockdown challenges to the now seemingly ‘normal’ overcrowding of wards.

Chief Operating Officer Chris Ash commented: “Hawke’s Bay DHB takes its responsibility of providing a safe working environment very seriously and is focussed on continuing to make improvements, where it can, to better support staff. In recent months the DHB has placed significant investment on the recruitment of senior clinical FTE with five additional Senior Medical Officers and 10 additional nursing staff to the emergency department. Redesign work to support better patient flow is also in progress.”

It’s fair to say DHB management doesn’t come to work each day intending to inflict misery on the clinical staff any more than the nursing team comes to work aiming to mistreat patients.

So what is the real problem here (setting aside for now the underlying reasons why too many patients are flooding to the ED in the first place)?

Ash also noted: “Pressures on emergency departments are being felt nationwide.”

That’s not a cop out. More than anything else, it’s clear that the NZ medical ‘team’ is understaffed in every job category – nurses, mental health workers, medical officers … you name it.

That not a HBDHB problem, that’s a national problem … and disgrace.

We are not ‘growing our own’ health care workers, and we’re making it virtually impossible for immigrants seeking to work in the sector to be either admitted or be given the residency status they need to stay here.

So this PIN – despite the local concerns that warrant it – should be directed at the PINheads in Wellington responsible for these policies and historic funding neglect. Plenty of blame to be shared by the Parties that have called the shots for the last twenty years.