Don’t use the c-word: Why Health NZ doesn’t want staff shortages called a ‘crisis’
Monday, 13 July 2026
A specialist recruiter says New Zealand is actively recruiting overseas doctors to fill shortages in gastroenterology, psychiatry, radiology, anaesthetics and general practice.
Recruiters are targeting clinicians from countries including Singapore, Malaysia, Israel and the United States, and competing with Australia for skilled specialists.
Former Palmerston North gastroenterologist James Irwin says several provincial hospital services are under severe staffing pressure.
Health NZ says it is offering incentives for specialists to work in provincial hospitals and is reviewing remuneration, while also working with medical colleges to encourage placements outside the main centres.
A specialist health recruiter has opened up on the challenges of plugging “dire” gaps in the workforce - as the doctor who sparked a national conversation about the issue described which areas of the service he believes are “in the shit”.
Prudence Thompson, a former nurse working in gastroenterology who now runs Accent Health, flew to Singapore on July 1 tasked with “selling New Zealand” to fill areas with “exceptionally short” staffing.
“I’m talking to 285 doctors here,” she told Stuff from the island nation. “Not just gastroenterologists but other areas in dire need - psychiatrists, radiologists, anaesthetists and GPs.
“Advancements in pharmacology and medical technology keep patients alive longer, but longevity brings an escalating burden of chronic illnesses.”
Recruiters are targeting countries with “comparable health systems”, such as the US, Singapore, Malaysia and, more recently, Israel, she said.
They face a fight for candidates, with rivals such as Australia offering more competitive salaries; so they’re selling the dream of life in New Zealand as much as remuneration.
“As an agency, we can negotiate incentives, but for clinicians leaving high-density hubs in Asia, the drawcard is not just financial, it’s paths to residency for the whole family,” said Thompson.
Her comments come in the wake of the controversy surrounding James Irwin’s resignation as the last remaining gastroenterology doctor at Palmerston North Hospital.
Irwin left the hospital in June and, despite it being funded for six full-time gastro specialists, services are currently being handled by locum and temporary specialists.
He said he made the decision because of workload.
Irwin managed 1200 “complex chronic patients” and said he was forced into triaging an unmanageable volume of referrals, reviewing inpatients and routinely declining clinical requests from local GPs.
‘No time to see patients’
“It was fighting fires, I couldn’t see everyone. If someone was really sick, their story would get to me and I'd give advice… but [there was] no time to actually see patients.”
Irwin told Stuff that he believed workforces at regional hospitals in Whanganui, Gisborne, Wairarapa and Nelson were also dangerously stretched.
“ENT [ear, nose and throat] services are in the shit, radiology services are in the shit and, at Wanganui Hospital, general medicine is in a dire situation.
“What's going to happen to provincial healthcare in New Zealand… let’s just say, without change, I don’t have a positive view of its future.”
Rural hospitals are facing “rocketing” demand, particularly in diagnostics, but many “are not meeting patient needs” due to insufficient staffing, says Deborah Powell, national secretary of the New Zealand Resident Doctors Association and Apex unions.
Sarah Dalton, the executive director of the Association of Salaried Medical Specialists, a union for senior salaried doctors and dentists, believes that provincial hospitals are “teetering” into “unsafe” for both patients and staff.
“They’re absolutely in crisis. Health NZ needs to incentivise and support doctors in smaller communities.”
When Stuff went to Health NZ for a response, we were told “it would not be helpful” to use the word “crisis”. A member of the organisation’s communications team said it could hamper recruitment efforts if potential recruits “read the story”.
When we got back in touch to see if they had anything to add, they said they would prefer if that wasn’t mentioned, with a different team member saying: “So we've asked you to take the word ‘crisis’ out. If you decide to run with it, that's up to you.”
A statement from chief clinical officer Richard Sullivan said “attracting and retaining specialists in provincial areas isn’t just about remuneration” and Health NZ was “working with medical colleges to encourage placements outside the main centres”.
“We are currently offering some allowances to specialists in provincial hospitals, like Palmerston North, while we review remuneration for provincial services more broadly.”
Sullivan said Health NZ will move, over time, to a consistent national framework for remuneration and allowances for specialists across New Zealand.
“We are doing national work to understand the differences in payments for gastroenterologists across New Zealand, in urban and provincial settings. One of the outcomes of this will be to make payments more consistent. We are working with our union partners on this important area.'
‘If I die, I will blame the Government’
Sarah Martin is among the patients affected by Irwin’s departure.
The 39-year-old businesswoman and mother of two says she’s battling a life-threatening inflammatory bowel disease and feels “abandoned” by the health service.
“If I die, I will blame the Government. I don’t blame James, he’s a wonderful caring doctor and how was he expected to do it alone? It’s the system at fault, not doctors, nurses, who work so hard with less and less.”
Had an experience at a hospital recently you’d like to share? Email annnemarie.quill@stuffdigital.co.nz
While Health NZ said it has “interim measures” in place for gastro patients at Palmerston North, Martin said she’d not heard from the hospital.
“I feel in limbo. I’m scared as I need colonoscopies for critical cancer surveillance, and waiting - it’s stressing me so much I’ve been in excruciating pain.”
It’s not just the gastro department at Palmerston North with gaps, she claimed.
“I was referred to a rheumatologist, but not seen. The [emergency department] is equally understaffed - I’ve waited hours and still not been seen.
'It’s continuity of care that’s the biggest deal for people with chronic illness. I work hard, and am usually a private person, but I’m speaking out as something needs to happen.”
Katherine Fraser-Chapple, Health NZ’s acting group director of Operations, MidCentral, acknowledged “we need to communicate better with patients of the gastroenterology service in Palmerston North.
“In April we communicated with GPs to reassure them that the gastroenterology unit at Palmerston North Hospital will continue to provide the usual services and remind them how they can get in touch for specialist advice.”
Patients waiting for surveillance colonoscopies, and general practice providers, will receive a letter from Health NZ in coming weeks, about arrangements for their care, Fraser-Chapple said.
A gastroenterologist would start at Palmerston North Hospital in September, she said.
When Stuff went to the office of Health Minister Simeon Brown for a response to Martin’s criticism of the Government, a spokesperson provided a list of achievements relating to health targets and said they should be given “equal weight” in our reporting.
The minister’s office highlighted three regions where certain measures had improved - trumpeting the record for elective treatment in the Mid Central area, which includes Palmerston North. The target was, by 2030, to have 95% of patients receiving elective treatment within four months. Mid Central was on track, with 81.3% in the first three months of 2026, compared to 75.9% over the same period last year.
But a closer look at the regional targets reveals that same region was going backwards on first specialist assessments. In the first quarter of 2025, 76.7% of patients were waiting less than four months for a first specialist assessment. Over the same period this year, that figure had fallen to 74.8%. The goal is to have 95% of patients waiting less than four months by 2030.
Mid Central also ranked second last against the emergency department stay target, with 59.2% of people who were admitted being discharged or transferred within the target six hours in the first three months of 2026, down from 60% over the same period last year.
And on the faster cancer treatment target - 90% of patients receiving treatment within a month of the decision to treat - Mid Central was close to the target at 87.5% in the first quarter of this year, but down from last year’s result of 88.3%.
Targets can mask reality
Irwin says data from targets can mask the reality for patients and workers, and claims other doctors - who are gagged from speaking to media because they still work in the public sector - feel the same.
“Tasked with meeting those targets, specific lists, say like colonoscopy, are kept down through aggressive, highly expensive outsourcing — bringing in external clinicians to perform rapid-fire procedures before returning home,” said Irwin.
“This leaves salaried public hospital doctors holding the bag for exhaustive, long-term patient management.”
The Government's focus on targets should be extended to attracting and keeping doctors, he says.
'If you're a New Zealand trainee and someone says to you, ‘Do you want to go and work in Palmerston North?’, you say, ‘Are you f…ing crazy? There's no one else there, there’s no one to supervise me… why would I want to do that?’ And they wonder why 40% of doctors leave after training.”