• Christchurch’s emergency department is seeing over 400 patients a day, raising concerns about safety. 
• Dr Kate Allan says overcrowding and patient harm incidents are occurring nationwide, not just at Middlemore’s ED. 
• Health Minister Simeon Brown highlights funding for urgent care services as part of fix, but emergency doctors and GPs say long-term planning and investment is needed. 

Official figures reveal more than 400 patients are turning up daily at Christchurch’s emergency department (ED) and others are already seeing “record numbers”. 

It is a pattern the head of the Australasian College of Emergency Medicine says is a “significant worry”. 

The Herald revealed on Monday serious concerns about patient safety and a lack of staff at Middlemore Hospital’s overcrowded emergency department last winter, which included more than 1500 patients being treated in corridors in the space of just 36 days. 

A review written by clinicians said there were 43 patient harm incidents in the same time period - some of which could have involved death or severe loss of function because of delayed care or medical error. 

The New Zealand chair of the Australasian College for Emergency Medicine and ED physician, Dr Kate Allan, told the Herald such issues are not isolated to Middlemore’s ED. 

“It is a significant concern, but it’s not unique to Middlemore. This sort of thing is happening across the country at a lot of our emergency departments and our hospitals,” she said. 

Dr Kate Allan is the New Zealand chair of the Australasian College of Emergency Medicine. Photo / Jason Dorday 

Allan said it was concerning that several EDs were already reporting significant numbers of patients. 

“Some departments are reporting that they’re having the highest numbers [of patients] they’ve had, so record numbers of presentations already, and we’re not hitting winter yet,” she said. 

Health New Zealand (HNZ) data provided to the Herald backs up Allan’s concerns, with Christchurch Hospital’s ED topping the list of the country’s busiest at the moment. 

Health NZ figures show Christchurch Hospital's emergency department has recently seen more than 400 patients turning up every day. Photo / George Heard 

Between May 14 and May 20, Christchurch’s ED saw an average of 413 patients every day, followed by Middlemore’s ED which saw 329 daily presentations over the same time period. 

The ED at Waikato and Auckland City ED are also under pressure. 

The following table shows on average how many patients are arriving at EDs on a daily basis around the country. 

Last year HNZ sent out a public alert when Christchurch’s ED hit 430 presentations a day, urging the public to seek alternative care if possible because it was “extremely busy”. 

A Middlemore Hospital ED worker, who asked to remain anonymous, gave the Herald an insight into the current predicament. 

“The volumes of patients through the doors increase every year but the resources never grow to match. The ED was built to receive 270 patients a day, and we average 360 and peak at 440,” the staff member said. 

Allan said ED overload had become “business as usual” for staff at many EDs, which she said was a “significant worry” when it came to the welfare of staff and patient safety. 

“All the low-lying fruit has been picked to improve things and we’re still running at these very high levels of occupancy throughout the system,” she said. 

Health Minister Simeon Brown has highlighted the progress being made to see patients in a timelier manner after the reintroduction of ED wait time targets, and said funding for 24-hour urgent care services would help busy EDs like Middlemore. 

“This service will reduce pressure on Middlemore Hospital and ensure people living in Counties Manukau have an alternative if requiring urgent or after-hours care,” he said. 

More than 50% of patients turning up at Middlemore’s ED are severely ill and need admission to hospital. 

Allan said boosting urgent care services was part of the puzzle but not a total solution. 

“You need long-term planning and investment to fix a very significant problem. We can’t keep doing what we’re doing,” she said. 

She said retaining and valuing staff was critical. 

Requests for staff ‘fallen on deaf ears’ 

A review written by clinicians and obtained by the Herald has raised serious concerns about staff and patient safety at Middlemore Hospital's emergency department. Photo / Jason Dorday 

A Middlemore ED worker told the Herald there was “longstanding inequity” in the way EDs were staffed. 

They said Middlemore ED had far fewer staff for the number of patients presenting despite having a more socially deprived and comorbid population. 

“Year on year requests for help have fallen on deaf ears. The volumes of patients through the doors increase every year but the resources never grow to match,” they told the Herald. 

The staff member said it was unfair on hardworking staff who were unable to provide timely care to their patients. 

“This winter will be awful, despite the reassurances from the executive and the Government.” 

A HNZ spokeswoman told the Herald the agency is committed to growing and retaining its workforce. 

She said Middlemore has recruited 20 fulltime registered nurses, five senior nurses, three senior registrars and one urgent care doctor in the past financial year. 

Five extra security guards had also been employed. It was not clear how many of the new staff in total had been diverted to the ED. 

“There is planning for additional staff in the current budgeting year,” she said. 

She said one hospital can’t be compared to another due to size, location, staff numbers, budget, management and other factors. 

‘Third World’ healthcare 

Dr Karl Cole is a GP working in Auckland's Papatoetoe and is a board member on the Royal NZ College of General Practitioners. Photo / Jason Dorday 

General practitioner Karl Cole, who works at Papatoetoe Family Doctors, said funding issues across the health system could see New Zealand witness “Third World” issues in terms of patient care. 

“If we keep on the same track, we’re just going to see hospitals and trying to see 900 people a day, Third World stuff where they shut the gates and people are just outside and they have to come back in the morning,” he said. 

He had “huge sympathy for my colleagues in ED” but stressed that healthcare must be seen as “one ecosystem”. 

He was critical of how funding was allocated, saying GPs were not around the table when decisions were made, and many were quitting or moving overseas as a result. 

He said the specialty of general practice was being gradually eroded and that was having a significant toll on the workforce, as many felt they were “second class citizens” in the health framework. 

He said a functional and properly funded primary care system was critical to alleviating pressure on EDs. 

“There’s clear evidence to show the benefits of primary care and helping prevent hospitals being overloaded,” he said. 

Brown celebrated “record investment” in health when the Government’s Budget was unveiled last week, saying the total spend on health topped $30 billion. 

However, there was widespread disappointment from GPs, including the Royal New Zealand College of GPs (RNZCGPs) medical director Luke Bradford. 

“The lack of any immediate funding for general practice and primary care in the Budget announcement to implement solutions that will alleviate pressures both on our workforce and in hospitals and EDs will be felt by all New Zealanders who access our services,” he said. 

The General Practice Owners Association (GenPro) chair Angus Chambers said the Budget “did nothing” to fix a funding and retention crisis in primary care. 

Cole, who’s also on the RNZCGP board, suggested a “separate isolated budget” was needed specifically for primary care. 

Special rooms have been built outside the practice where Cole works which he says will help his staff deal with a predicted surge of patients this winter - a service he said will prevent patients attending overloaded ED waiting rooms. 

“It’s like waiting for a punch to come to the stomach. As soon as the temperature starts dropping, the bronchiolitis, the respiratory problems, on top of the exacerbation of the chronic medical conditions, all start to come in.” 

Allan agreed that primary care was essential. 

“If we can keep New Zealanders healthy, we will be in a much better place. That starts with preventative care and good primary care and access to primary care,” she said. 

Michael Morrah is a senior investigative reporter/team leader at the Herald. He won News Journalist of the Year at the 2025 Voyager Media Awards and has twice been named reporter of the year at the NZ Television Awards. He has been a broadcast journalist for 20 years and joined the Herald‘s video team in July 2024.