Disagreement has emerged between the New Zealand Nurses Organisation (NZNO) and Health New Zealand (Health NZ) over claims that Whanganui Hospital’s Emergency Department (ED) operated at 680% capacity during a seven-day period in September.

NZNO delegate Kathryn Fleming expressed serious concerns about the state of the hospital’s ED, attributing overcrowding and staffing issues to underfunding and inadequate infrastructure maintenance. Fleming said the department frequently declares a code red due to the large number of patients requiring triage and care, describing the environment as a daily challenge for staff who face difficult decisions under pressure. She detailed that between September 2 and 9, the department, which has 15 emergency beds and seven acute assessment beds, handled 503 patient arrivals—averaging 79 patients per day. Fleming argued that this volume posed a significant health and safety risk and made it difficult for staff to take breaks, citing a recent incident where a patient lost consciousness and was only saved by vigilant staff monitoring.

Fleming called for an urgent overhaul of the health system, emphasizing the need for increased funding of primary care services to reduce ED overcrowding. She suggested that better investment in Te Whatu Ora, the national health organization, would improve staff retention and hiring, as well-supported employees are less likely to leave.

In response, Health NZ group director of operations for Whanganui, Kath Fraser-Chapple, challenged the accuracy of the 680% capacity figure. Fraser-Chapple explained that the figure appeared to reflect patient turnover across the entire week rather than the actual number of patients present in the ED simultaneously. She noted that hospitals nationwide are experiencing sustained pressure due to a high incidence of winter illnesses and increased demand for acute care, although demand has recently begun to ease.

Using hourly data for the period September 2-9, Fraser-Chapple said the highest recorded occupancy was approximately 253%, equating to about 50 patients in the department at one time. She acknowledged the significant pressure placed on services but stated that describing occupancy as 680% was misleading. Fraser-Chapple praised the ED staff for their dedication and professionalism under challenging conditions and underscored Health NZ’s priorities of supporting staff wellbeing, maintaining safe staffing levels, and ensuring timely patient care.

She encouraged anyone in need of emergency care to continue seeking help without delay, reaffirming that Emergency Departments operate 24/7 and prioritize treatment based on clinical urgency.

The debate over ED capacity comes amid broader concerns about hospital overcrowding in New Zealand. Earlier reports revealed that a man died after waiting nine hours in Waikato Hospital’s ED waiting area, prompting ongoing investigations. Similarly, Christchurch Hospital’s ED has been reported to operate at up to three times its capacity, with patients frequently held in corridors due to a lack of available beds elsewhere in the hospital.