Media release from health and disability commissioner Ron Paterson

Health and Disability Commissioner Ron Paterson has found that the Waitemata District Health Board did not do enough to address longstanding problems at North Shore Hospital. This compromised the care of five elderly patients in 2007.

Mr Paterson has completed an inquiry into the care of the five patients who were treated in the hospital's Emergency Care Centre (ECC) and two medical wards between April and October 2007. The inquiry was initiated by the Commissioner after he received a number of complaints raising similar issues.

In his report, Mr Paterson acknowledges that there have been "valiant efforts", over a number of years, to fix overcrowding and staff shortages at North Shore Hospital, and address population growth. However, he concludes that Waitemata DHB did not act with sufficient urgency, early enough. As a result, in the winter of 2007, the ECC and wards 10 and 11 were ill-equipped to cater for the flood of patients. The acute services at North Shore Hospital were "overwhelmed".

Mr Paterson states that the five patients' care was compromised by inadequate systems and the failure of the DHB to resolve overcrowding and staff shortages. The patients were "let down" and the Board and its senior management must accept accountability for this.

Mr Paterson's findings include:

•    Delays and omissions in care, and deficiencies in communication with the patients and their families.

•    Three of the patients were treated in a "disrespectful and undignified manner" in ECC.

•    While the standard of medical care was largely reasonable, the nursing care was not. Nurses did not have time to care.

•    The failings were not the fault of individual staff but the result of systemic issues, overcrowding, and pressures on staff. The DHB must accept accountability for this.

Mr Paterson concludes that Waitemata DHB's care of the five patients breached various rights under the Code of Health and Disability Services Consumers' Rights  (the Code). He also recognises that Waitemata DHB is not the only DHB facing overcrowding, staff shortages, and pressure in its emergency department. Although the recommendations in Mr Paterson's report are primarily for Waitemata DHB, they are significant for acute care services nationally.

Findings and recommendations

The full findings and recommendations, along with an executive summary, are found in the Commissioner's report.  The report has been partially anonymised to protect the privacy of the patients and other individuals.

Background information

The Code of Health and Disability Services Consumers' Rights is a regulation under the Health and Disability Commissioner Act 1994. It confers a number of rights on all consumers of health and disability services in New Zealand, and places corresponding obligations on the providers of those services, including hospitals.

At the end of an investigation, the Commissioner reports his findings to the parties and other relevant agencies (in this case the Ministry of Health and other DHBs), registration boards, and professional Colleges. He makes recommendations (which are followed up), and he publicises any relevant lessons.