Photo: RNZ / REECE BAKER
A senior doctors' union says it's frightening how close Health New Zealand came to axing a section of maternity beds at Wellington Hospital.
Health NZ announced on Tuesday it would no longer use maternity and gynaecology beds for emergency department overflow, after RNZ revealed the proposed trial on Monday.
The news was welcomed by one expectant new mum as well as senior doctors' union the Association of Salaried Medical Specialists (ASMS), which said the U-turn was the right decision.
ASMS industrial officer Jane Lawless said Health NZ could not fix a crisis in New Zealand's emergency departments by creating crises in hospital wards.
"We had a similar problem late last year at Mid-Central [Palmerston North Hospital] when ... there was an intention to just start moving ED patients into ward corridors.
"We had to push back really hard and get them to understand from an evidence-based point of view why that really wasn't going to be a solution.
"Everybody's concerned about the ED crisis but that doesn't mean that you create new crises in an attempt to solve that."
Lawless said the way the Wellington situation had been handled was "of great concern".
"I think we can be quite confident that there wasn't adequate consultation and when you look at the reaction from clinical staff I think that bears that out as well."
Lawless said all hospital patients were vulnerable but the potential impact of the proposal was conveyed to her by a hospital doctor.
"She said if a baby doesn't have the care it needs in the first hours of its life and it ends up with a catastrophic brain bleed - well that's a disability for life.
"She was just pointing out how close to the edge things are and therefore how extra cautious we need to be when we make changes to models of care."
Lawless said clinicians had plenty of thoughts about how to resolve some of the pressure in ED but they were not necessarily being heard.
First-time mum Ashley Godwin said she was so worried about the proposed trial she considered giving birth at another hospital.
"I was messaging a few friends being like 'Oh should I consider going and having the baby somewhere else where I know that there might be a little bit more support afterwards' or, you know having to prepare for that conversation with my midwife on Friday of what happens if I do get kicked out straight away or if I turn up for an induction and they delay that by a few days 'cos there's not enough beds.
"So I definitely have felt a huge sense of relief with the announcement."
She commended Health NZ for listening to clinicians, midwives and the public over their concerns and said the news was a weight off her mind.
"When you're thinking about being in labour and going into the birthing unit, and what that looks like post-birth, not having to worry about the fact that you might get kicked out straight after having a baby not knowing what you're doing, not having that breast-feeding support or just not having the proper time to recover before going home, [the turnaround] just makes the whole experience a little bit more bearable in the coming weeks."
Health New Zealand Capital, Coast and Hutt Valley group director of operations Jamie Duncan said in a statement the trial to "reallocate unresourced maternity and gynaecology beds" at Wellington Hospital would not proceed.
"We understand the importance of these services to women and families across the region, and after careful consideration of feedback from a broad range of stakeholders, the proposal will not continue."
Duncan said Health NZ remained committed to "optimising the use of all available beds across our facilities, particularly during peak periods when demand increases significantly".
"We will continue to work with our staff and clinical leaders to explore sustainable ways to enhance patient flow and improve access to timely care for all patients, while ensuring the specialised support that maternity and gynaecology services require."
Duncan said patients were at the centre of every decision made.
"We will continue to work closely with our clinical leaders and teams to ensure the best possible outcomes for women accessing maternity and gynaecology care."
Health NZ acting chief executive Robyn Shearer said it was an opportunity to listen to staff, but they will now have to go back to the drawing board.
"We just want to look at other options that might be available to us," she told Morning Report. "We did have a trend, we were not filling all of those beds, and it seemed like something we could trial.
"Clearly, the teams weren't happy about that, and we now have to have a think about other options."
Shearer said that was still really important as there was still the issue of long wait times in the emergency department, and limited capacity for medical and other beds.
"We're still going to have to look at other options across the hospital and that remains a challenge for us," she said.
MERAS Union co-leader Caroline Conroy said it was a good decision, but wish senior clinical leads were spoken to earlier to get a better understanding that it wasn't going to work.
Conroy said her issue was that there was no 24/7 woman's assessment unit for the maternity service, as it is one of the busiest maternity services in the country.
"This is an aspect of their service that's really lacking and that would be a good use for those unresourced beds at the moment," she told Morning Report.
"The thing is you always need empty beds in a maternity service of this size because you've constantly got women coming into the service in labour to have babies or for other complications ... there needs to be a maternity bed available for them to go into."
Conroy said an after-hours GP service could alleviate the overflow of patients in the emergency department.
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