6. Question No. 6—HealthDr SHANE RETI (National) to the Minister of HealthQuestion No. 6—Health6. Dr SHANE RETI (National) to the Minister of Health: Which are the three hospital emergency departments with the greatest number of nurse vacancies as a proportion of their normal full-time equivalent roster and what are those proportions in each case?Hon ANDREW LITTLE (Minister of Health): I've been advised that data on nurse vacancies specifically in emergency departments (EDs) is not routinely collected at a national level. This information sits with individual emergency departments and would need to be manually collected and collated from all districts which hasn't been possible in the time available. However information related to this question was collected on 2 November this year in response to the member's written question No. 39263. At this time the three hospitals with the highest vacancies in their EDs were Middlemore Hospital 29.2 vacancies; Hawke's Bay Hospital and Wairoa Hospital combined 27.43 vacancies; and Wellington Hospital 20 vacancies. I can also report that as at 30 June 2022 the total number of employed nurses at Counties Manakau District Health Board was 275 Hawke's Bay District Health Board was 95 and Capital and Coast District Health Board was 129. Pressures on emergency departments go back many years and we have many measures under way to address them.Dr Shane Reti: How does he explain to people in rural places like Te Kuiti and Taumarunui who may wait hours in their EDs today that each of their hospitals is short three ED nurses on average and yet he will not give nurses a day-one pathway to residency?Hon ANDREW LITTLE: Firstly I rely on the incredible front-line health managers that we have to make sure that particularly for EDs they do the best they can to get the necessary nursing complement in place. Typically what happens in hospitals—large and small—is that if there are material gaps in the shift roster for an ED hospital managers will pull nurses from other areas of the hospital to make sure that they are properly staffed. I take my hat off to not only ED staff and nursing staff generally but to those managers who are dealing with those pressures on a day-to-day basis in very difficult circumstances. On the issue of the straight to residency pathway for nurses I think we've been haggling about this for some time. I think the member and his party routinely overlook the nurses who are arriving from overseas with overseas qualifications; 4300 have crossed the border in the last year alone and 634 registered with the Nursing Council of New Zealand just in September. We are attracting nurses from overseas here to New Zealand; we still have a long way to go to fill the vacancies that we've got but I back our health leaders to do the right thing in these very difficult circumstances.Dr Shane Reti: What does he think will be the impact on ED wait times at Middlemore Hospital today due to the shortage of 29 ED nurses as advised in his response to written question No. 39219?Hon ANDREW LITTLE: As I said before I take my hat off the front-line health managers who every day are dealing with these challenges and who redeploy nurses from other parts of the hospital to meet those gaps. What I can also say too is that there are people who turn up to ED and who have to wait longer than is desirable—particularly those with less-acute conditions. What they can be sure of however is that they will still get care in ED. I met a person the other day whose opening remark to me was I'm one of those who waited 24 hours at a MidCentral ED." I said to him "Well I'm sorry to hear that. How did it go?" He said the care he had was impeccable he said he was well looked after and when he did get admitted to a bed—he needed to be there—he was very pleased with the level of care that he got even if he had to wait longer than was desirable in that ED.Dr Shane Reti: What does he say to ED specialists who say that every day in every ED is another Middlemore tragedy waiting to happen given his answer to written questions showing an average of 4000 people leave ED each month because of wait times yet within 24 hours on average 400 are so ill that they have to return to ED and are admitted?Hon ANDREW LITTLE: We know that EDs are under pressure and have been for some time. That's why it was so good to come together last Saturday with health professionals and health leaders all across the country to talk just about how we deal with this problem that has been many years in the making. You know when you underfund the health system for as long as it was prior to this Government coming into force it was important that we actually not only provide the additional funding but actually start to put together the long-term plans that we need. What is really disappointing is that that member who had the opportunity to be part of that really important discourse—because he's spent months criticising what's happened—did not turn up.Dr Shane Reti: When he just despairingly said in the House that nobody from the Opposition bothered to turn up to his health workforce hui last Saturday isn't it more troubling that two of his three associate health Ministers didn't turn up and neither did any of Labour's four Health Committee MPs and doesn't this show that Labour MPs want to be as far away as possible from the unfolding health crisis for which he is responsible?Hon ANDREW LITTLE: What's really disappointing is that when so many people recognise that our health system has major challenges and we have a Government that has put record sums of money into fixing those problems we have a party opposite who has no plan and just wants to play politics with people's livelihoods and people's lives. I stand by the measures that this Government has taken to put additional funding into our health system; to rebuild our mental health services that were left neglected for so long; to pay nurses more whose pay had gone backwards in real terms under the previous Government—a Government that has not frozen Pharmac funding for three years and has not frozen investment in buildings and infrastructure as the previous Government did. This Government is serious about improving our health system and cleaning up the mess left by the previous Government."