11. Question No. 11—HealthDr SHANE RETI (National) to the Minister of HealthQuestion No. 11—Health11. Dr SHANE RETI (National) to the Minister of Health: How many nights since 1 July 2023 have there been no junior doctors available to cover overnight ED shifts at Palmerston North Hospital and how many similar roster gaps are there through to the end of October? Hon Dr AYESHA VERRALL (Minister of Health): I am advised that since 1 July 2023 there have been six nights with no resident medical officers where two senior medical officers covered the night duty in the emergency department (ED). The current roster goes to 15 October. There are no roster gaps in September and three nights currently in October with gaps yet to be filled. MidCentral is making every effort to mitigate roster gaps and recently the senior medical officer team has reviewed current vacancies and stepped in to provide additional support. I am grateful to them for their contributions. Despite these challenges I can confirm MidCentral is on track to meet planned care targets. Dr Shane Reti: What responsibility does she take for a recent weekend at Palmerston North ED where 14 patients spent more than 24 hours sitting in chairs waiting to be admitted? Hon Dr AYESHA VERRALL: We do not like to see those sorts of waits. That is why we have funded that hospital to develop additional space including the recently opened 12-bed emergency department observation unit. In addition Palmerston North is one of the hot spots with a number of measures in place to address acute demand. Dr Shane Reti: What does she say to the wife of an elderly man taken to Palmerston North one evening who hearing nothing turned up at ED the next morning to be told he still hadn't been seen and there was my poor old husband stooped over in the chair asleep confused incontinent and freezing"? Hon Dr AYESHA VERRALL: That is an extremely distressing story to hear and if that member wants to share details of it we will make sure that it is followed up on. Dr Shane Reti: What was Health New Zealand's response to the clinical director of Palmerston North ED who stated that his hospital "is at serious risk of being unable to provide an emergency medicine service"? Hon Dr AYESHA VERRALL: That is a very serious concern and I understand—as I outlined in my primary answer—a number of steps are under way to make sure that roster gaps are addressed. But I have a wider concern when clinicians express that they cannot resolve their concerns through regular processes. That is why Te Whatu Ora is developing an external rapid review team to assess and address these types of situations. It will draw on national and international best practice to improve performance and learn and adapt across our hospital system. Palmerston North will be the first hospital to have the opportunity to use this model but this team will be available to assess events in other hospitals as needed over the coming months. This new rapid review team will support clinicians and other hospital workers to tell their side of things to an expert reviewer so that rapid solutions can be found. This process does not replace existing line management health and safety or quality assurance processes which are of course the first port of call. Dr Shane Reti: Further to that answer is she shutting down clinicians from going into the public domain when they feel they are getting no relief or remedy from the Minister and her office? Hon Dr AYESHA VERRALL: No we are taking their concerns seriously and providing a forum in which they can be heard."