Southland Hospital struggling with ‘too small’ emergency department

Problems with the hospital's "too small" emergency department are outlined in information prepared for former Health Minister Shane Reti in December 2024, released to Local Democracy Reporting under the LGOIMA.

The three-page document discussed the hospital’s struggling emergency department and operating theatres which have been waiting on upgrades since 2021 when funding was allocated.

“Southland Hospital is experiencing significant capacity constraints in ED (emergency department),” the report stated.

“The ED is too small to allow for the efficient flow of patients, this leads to extended times for patients to be placed in a clinical space to be assessed.”

A lack of specialised treatment spaces in the department meant it was not complying with relevant standards of “safe, effective and dignified care”, the document said.

“The ED is not equipped to sustainably and safely treat infectious patients.”

Meanwhile, demand was only increasing.

In 2024, the department was tracking at 2,015 patients per bed compared to recommended targets of between 1,000 - 1,500.

A shortfall in theatres was also hitting the hospital hard, with Southland now home to a “stringent” eligibility criteria and some of the highest thresholds for surgery in the country.

At the time the information was prepared in December, there were 1,071 patients waiting more than four months for surgical procedures.

High demand for acute and trauma care — especially from Queenstown — was straining resources, it said.

Surgeons were not being fully utilised, and a further 90 surgeries could be completed each month if more theatres were created.

The initial business case from 2021 estimated a need for two more operating theatres.

Health New Zealand Te Whatu Ora would not give the current budget for upgrades to the hospital, but said $3 million had previously been allocated for theatre capacity and $5 million for emergency department expansion.

The combined $8 million is deemed insufficient without significant compromises, the document said.

A more accurate figure is expected as part of an updated concept design and business case, but it is expected to take a further two years to deliver the upgrades once the case is approved.

Issues with sleeping facilities were also noted, as the current arrangement did not satisfy the multi-employer collective agreement.

The report said the hospital was built with the expectation the region’s population would decrease, but it had done the opposite.

It also highlighted pressure resulting from the closure of Invercargill’s urgent doctors in March 2024 and a struggle to recruit new GPs.

Local Democracy Reporting asked for notes and minutes from a February meeting between Southland District Council and Te Whatu Ora, but none were taken.

A spokesperson for Te Whatu Ora said they understood the two parties met regularly.

LDR is local body journalism co-funded by RNZ and NZ On Air