Healthcare workers are pushed beyond safe limits, and it’s getting worse

Sunday, 15 June 2025

Ryan Thompson is a Gisborne-based registered nurse who works in primary care.

OPINION: Three years ago, I wrote publicly about New Zealand’s healthcare system on the brink of collapse.

What followed was a chorus of voices: doctors, nurses, lab staff, rural providers, all reinforcing the same message. Since then, things have only spiralled down, and hidden waitlists, declined referrals and stretched workforces are barely sustaining the appearance of access.

Back in 2022, I managed the plastics portfolio at Gisborne Hospital, a regional service coordinating care for trauma, burns, and heaps of skin cancers, all without in-house specialists. Despite our results, repeated requests for permanent staffing were met with delay. “We know we urgently need our own specialist — maybe we can add this to the 10-year plan,” was the best we were offered.

Since leaving hospital-based care, I’ve worked in primary care as an advanced practice nurse. Like many, I now operate near the top of scope, not by ambition, but by necessity. With GP recruitment and retention in decline, many practices are relying on experienced nurses to help shoulder the growing burden of care.

For many of my patients, it’s barely possible to get them in front of the right specialists. Recently, I tried to use my old sales pitch to expedite a patient with aggressive facial cancer. I tried ENT and Plastics both, only to find it would be two months before either was back in the region. I cornered one of our three general surgeons with photo evidence while getting a coffee. His reply was resigned: “Send it to us - we’re the last ones standing.”

Some interventions being denied are not life-saving, but they are undeniably life-changing. In Gisborne our waiting lists are drowning in children requiring grommets who risk hearing loss lasting a lifetime. Those awaiting elective joint replacements hoping to return to active lives instead of being bound by pain. Patients whose sight fades away they await their specialist intervention.

This has created a silent two-tiered system, where those who can afford private care move ahead, while those who cannot are left to deteriorate. Heathcare is time-sensitive.

These shortfalls impact healthcare workers as much as they do patients. I work alongside clinicians pushed beyond safe limits physically, emotionally, and ethically. Colleagues stay late, skip breaks, and carry the weight of delays they can’t control. There’s a growing moral distress of knowing what a patient needs but being unable to deliver it. Healthcare runs on more than pay. It runs on meaning, purpose, and the ability to deliver acceptable standards of care - and worsening outcomes are chipping away at our integrity and wellbeing.

Honest public conversations - however uncomfortable - are the only way to rebuild trust. At present, a chasm exists between Te Whatu Ora and healthcare providers at every level. Right now, senior medical officers are striking. Laboratory staff are striking. Healthcare wages are falling even as workloads rise and patient outcomes worsen.

We need more than quiet public sympathy. We need civic solidarity. Healthcare workers are not asking for applause - we’re asking for the collective voice and action of the public we serve, and we need the Government to start listening.

Investing in healthcare, and primary care in particular, shouldn’t be a lightbulb moment. It’s common sense. Before heat pumps, there are wool jerseys. Before ICU beds, there are clinic visits. Primary care keeps people who can access it out of hospital.

When people do need secondary or tertiary care, we must listen to those providing it, and move away from our flawed one-size-fits-all approach.

There’s no point putting new tyres on a car with no fuel - or adding fuel when there’s no car.

What do you think? Email sundayletters@stuff.co.nz. Please include your full name and address.