0:00

I'm Sharon Brett Kelly and

0:02

today on the detail I'm

0:05

outside the brand new surgical

0:07

centre on Auckland's North Shore.

0:09

It's called Tautara Homaru. It's

0:12

all finished. You can, even walking

0:14

around it, you can see that

0:16

there's beds in there, there's furniture

0:18

wrapped in plastic. It is all

0:20

ready to go. But there's

0:23

no people in there and

0:25

we actually don't know when it will

0:27

start working as a hospital. At

0:30

the same time, there are

0:32

hospitals around the country crying

0:35

out to be upgraded and

0:37

we all know about the long,

0:39

long lists of people waiting for

0:42

surgery. So what's going on here?

0:44

Well, I'm with RNZ's health correspondent

0:46

Rowan Quinn who broke this story.

0:49

What is going on here, Rowan? It's

0:51

a big question, Sharon. It's been in

0:53

the pipeline for a long time. So

0:55

it was years ago when it was

0:57

still, we still had district health boards

0:59

that this building, work was

1:02

started on this building and it

1:04

replaced the old maternity hospital

1:07

that used to be here. In

1:09

the old days when they first started

1:11

talking about it, they called it a

1:13

new hospital. So it really is hospital

1:15

size. It's been compared to a similar

1:17

size to Southland Hospital or Taranaki Base

1:19

Hospital. And as you

1:22

said, it's there, it's ready to go, but no one

1:25

can go in it yet. Now, why? That

1:27

is a big question. At the very most

1:29

simple level, I guess you could say there are

1:32

no staff in it and it doesn't yet have

1:34

an operating budget. So what

1:36

Te Fatu Ora says is

1:38

the reason that hasn't happened

1:41

is that it didn't want

1:43

to take valuable resources that are doing

1:45

operations in other parts of the city

1:49

and divert them here if it

1:51

wasn't ready to go. That's what

1:53

I kind of don't understand. I

1:55

mean, it's a four story building,

1:58

costs $320 million. This

2:01

has been on the books for a

2:03

long long time. I don't understand why

2:05

it can't be organised that there

2:07

are people to work in it. And that's

2:10

what doctors here will tell you too. They've

2:12

seen it going up floor by floor. They

2:14

say they are looking out their windows in

2:16

the old hospital building and going, why can't

2:19

we come over to this one? They

2:21

can't understand the argument that

2:23

Te Fatiura is putting up.

2:27

We have these surgical waiting lists and

2:29

everything is managed as a region

2:31

now. So this facility here is

2:33

going to treat patients

2:35

from Whangarei to right round

2:38

the Auckland region. The

2:40

Whaita Matar district which is where we are,

2:42

that's in North and West of Auckland, South

2:44

Auckland, Central Auckland. So we have

2:46

these big waiting lists and

2:49

Te Fatiura has to decide

2:51

where all those surgeries will be done. And a lot

2:53

of them are done in the public system. A lot

2:55

of them are currently done in private hospitals. So

2:58

what Te Fatiura is saying is they

3:00

weren't 100% that this would be finished

3:03

in April. So they were reluctant

3:06

to take people

3:10

and staff and the resources

3:12

needed to do those surgeries to

3:14

commit them to this building when

3:17

it wasn't, if they weren't 100% sure that

3:20

it was going to be finished. So then patients

3:22

that were booked into surgery might not have it

3:24

happen. Staff would have been

3:27

diverted here and then it wouldn't

3:29

have gone ahead. But of course what these doctors

3:31

here at the hospital are saying is, as

3:33

you pointed out, it's been years and years

3:36

and years in the making. It

3:38

was originally supposed to open in December 2023

3:41

but for a long time now it's

3:43

been April as the date. They just

3:45

can't understand why it's not up

3:47

and running. So you can do it for

3:49

a walk around and you can hear in

3:51

the background that there is some work going

3:53

on outside. It looks like it might be,

3:55

I don't know, landscaping work or something to

3:58

do around the back of the hospital. place

4:00

but it's all beautiful, it's actually there's

4:02

trees, it's all planted, I mean it

4:04

is ready to go. Yeah. So and

4:07

you were telling me that actually it's had sign

4:09

off from Auckland Council. Yes, I think there's a

4:12

little bit of tinkering still going around on the

4:14

edges, you know we saw a few guys

4:16

with ladders up look like they were doing something with the

4:18

lights but the lights are on, you can see all the

4:21

way up to the fourth level

4:23

of this that there are lights on but yeah it's

4:25

had Council sign off, the Tifatu Ora

4:27

says construction is complete. I guess now

4:29

the fact that the opening is delayed

4:32

means that they do have a little

4:34

bit more time to tinker around the

4:36

edges. So I should

4:38

mention that it's a windy, it's a stormy day

4:40

here. Yeah. But can we take it

4:42

back? When did

4:44

you first hear about this Rowan? I

4:47

first heard about the building years ago when I

4:49

used to come and go to the HV meetings

4:51

and they were very excited about this happening and

4:53

pulling down the old building here that

4:56

was more than 50 years old. I think

4:58

it had been the old maternity hospital and

5:01

a lot of babies born here

5:03

but then just at the

5:05

start of this year I just started to

5:07

hear whispers where people were like, hmm, Tautara

5:10

Homaru is due to open in

5:13

April. There are whispers among

5:15

doctors that it doesn't have an operating

5:17

budget and that it doesn't have

5:19

staff. So yeah, I just

5:21

waited till April and tried

5:24

to find out when it was opening and

5:26

Tifatu Ora wouldn't say when it was opening

5:28

and eventually it was very clear that it

5:31

wouldn't be this month and indeed it

5:33

doesn't have an operating budget. When I

5:36

spoke to Fiona Dugan who is in

5:38

charge of hospitals for the whole country

5:40

for Tifatu Ora, she said

5:42

that they were still working through

5:45

the financial 24-25 year budget. We

5:47

don't have a date for it

5:49

to be fully up and running because that

5:52

is a long-term strategy requiring us

5:54

to be funded for additional

5:56

work so that we can

5:58

make it best. of

6:00

the full capacity. So there's

6:03

a big question mark over how much

6:05

money is going to be needed to

6:07

fund this and how much is going

6:09

to be allocated to fund its operation.

6:12

You and I have talked a little bit in the

6:14

past about how difficult it is

6:16

sometimes getting information out of to futter

6:19

order about important things like this that

6:21

you think the public really need to

6:23

know about. Was it

6:25

forthcoming on this? Eventually

6:27

I did get an interview with Fiona

6:29

Dugan who's in charge of all those

6:32

hospitals. It did take

6:34

me quite a while to tie

6:36

down the fact that it wouldn't

6:38

be opening in April. They

6:41

just kept saying it'll be opening

6:43

mid-year and I thought well technically

6:45

April could, it was borderline mid-year.

6:49

Eventually I did get that. I'd like

6:51

to know more about the business case

6:53

and the operating budget but some of

6:56

those things do fall into the commercially

6:58

sensitive nature of

7:00

official information. So we'll see. So

7:03

what is the latest, what's Te Futtu Ora

7:05

telling you about the opening

7:07

date? Well Shane Reeting, the Health

7:09

Minister, he's given us a little bit

7:11

more of an indication of the

7:13

opening date. I couldn't get anything

7:15

beyond mid-year from Te Futtu

7:18

Ora but Shane Reet says he thinks

7:20

it should be open by June. And

7:23

by the statement that Health Workforce is the greatest

7:25

hurdle we have in the health system. And

7:27

your staffing for this is a factor that

7:30

has resulted in it being delayed an opening.

7:33

I asked the Association of

7:35

General Surgeons about could you get

7:37

a hospital, a facility this size

7:39

up and running in that time.

7:41

And they said you could if

7:43

you really cracked onto

7:45

it but it would be hard. You

7:48

know you need a lot of staff here. You need

7:50

nurses, you need anaesthetic

7:53

technicians, you need

7:55

dedicated cleaners and security guards. I

7:58

think recruitment has already started. them

8:00

and for anesthetic technicians. Surgeons the

8:02

way it works they come and

8:04

go from hospitals. Not every surgeon

8:06

that works here will be dedicated

8:08

to this facility so

8:11

that's less of a problem but yeah it's a

8:14

big job to try and get it up

8:16

and running by June and that's for the

8:18

first two stages. Oh okay. And the first

8:21

sorry that's for the first stage which

8:23

is the first two levels but

8:26

Shane Ricci tells us that that

8:28

includes all eight operating theatres that

8:30

are in here and also the four procedure

8:32

rooms for endoscopies so those are colonoscopies,

8:35

gastroscopies, you know

8:38

things that they stick cameras in your body to see

8:40

what's going on. So he says that

8:42

that first stage which contains all of

8:44

those things should be open

8:47

and that first stage also includes

8:49

90 ward beds in

8:51

total there be 150 ward beds in

8:53

here so if it is up

8:56

and running by June that'll

8:58

be a lot of the surgical capacity just

9:00

not so much of the ward and

9:02

bed capacity. Will it

9:05

add to the capacity that's

9:07

already here in this area

9:09

or is it taking people

9:12

from one hospital and putting

9:14

them in another? It's a little bit of

9:16

both. So Shane Ricci has told us that it'll be 8,000

9:20

operations can be done here a year when it's

9:22

fully up and running and 7,500 of those

9:25

other endoscopy procedures so 15,500

9:27

procedures. Tafati

9:31

Ora says some

9:34

of those will be diverted from private

9:36

hospitals which it is using at the

9:38

moment to try to clear those really

9:40

long waitlists that we've got. Data shows

9:43

the number of public funded

9:45

inpatient surgeries done in the

9:47

private sector has actually doubled since

9:49

2015 to 20,000. It's

9:53

happening not by stealth but

9:55

simply by creeping by the fact that the

9:57

public system is creaking that they haven't got

9:59

enough people. People essentially it's this workforce

10:01

crisis again. So that's quite costly

10:03

to outsource to the private sector. So those

10:05

will come back in house. Also, it has

10:08

been doing a lot of weekend catch up work. The

10:11

country's biggest district health board can't cope with

10:13

the demand for elective surgery and has decided

10:15

to do operations on the weekend in a

10:17

bid to keep up. Operations

10:19

are regularly being called off at

10:22

Waitematar's North Shore and Waitakari hospitals

10:25

and at its elective surgery center because

10:27

of a shortage of nurses. It's

10:29

another example of a health system under

10:31

strain. So some

10:34

of that will come back in here because

10:36

that's not sustainable long term, you know, for

10:38

your workforce. So it

10:40

will be alleviating some of the existing

10:42

stress but also adding some capacity. I

10:45

don't know the ratio. No, that will

10:47

be. We probably no one does. No.

10:50

It's up and running. That's

10:53

the sound from a video published

10:56

in the Northern Advocate last week

10:58

showing water from the leaking roof

11:00

of Whangarei Hospital dripping into

11:02

a bucket on the floor of

11:04

the radiology department. It's

11:07

a hospital in dire need of

11:09

an upgrade, as this doctor

11:11

explains. We outgrew that hospital

11:14

decades ago. The hospital itself is around

11:16

70 years old. It's

11:18

well past its used by date. We've

11:21

got problems of chronically leaking roofs,

11:24

an undersized ED and other units that are

11:26

probably 50% smaller than they need

11:28

to be. And this is

11:30

in a region with immense poverty,

11:34

some of the highest levels of unemployment in the

11:36

country, highest levels of working

11:38

poor in the country of deprived children,

11:42

a region that's grown something like 18% in five years as

11:46

people move to Northland and one of

11:48

the highest rates of elderly in the country. I

11:50

think 20% or 21% elderly. Last

11:54

month, the Prime Minister turned the first sod

11:56

on a $60 million radiation

11:59

cancer. facility in Whangarei to

12:01

be finished in 2026. But

12:04

that's one part of a $750 million

12:06

upgrade funded

12:09

by the previous government. Shane

12:11

Ressie says he remains committed to

12:14

the project. It's just

12:16

not happening quickly. Then

12:18

there's the $1.6 billion

12:20

Dunedin hospital where costs just

12:22

keep rising. Beds and operating

12:25

theatres have been cut from

12:27

the design of a new

12:29

hospital in Dunedin because of

12:31

increasing building costs. Tofatu Oda

12:33

says an extra $200 million

12:36

is needed to deal with

12:38

cost pressures largely caused by

12:40

inflation. But after some till and

12:42

fro, the government has put up an extra

12:44

$110 million, leaving a $90 million budget shortfall.

12:46

And remember the

12:51

waiting list? 30,000 people

12:53

around the country waiting at least

12:56

four months for non-urgent surgery. Meanwhile,

12:58

we're looking at a state-of-the-art

13:00

surgical unit all ready to

13:02

go and empty. So

13:05

is it bad planning by Tofatu

13:07

Oda? Here's Rowan again. I

13:09

mean, doctors will tell you it's very bad

13:11

planning. They've been crying out for years to

13:14

improve the infrastructure of this hospital and

13:16

many others. It's expensive. The last

13:18

government started quite a lot of

13:20

capital work to try to upgrade

13:23

them, but it was really just

13:25

the beginning. It is a problem

13:27

for New Zealand that these public

13:29

hospitals are really in dire need

13:31

of an upgrade. What about the

13:33

shortage of staff? I mean, you

13:35

followed this story up

13:38

with another story saying that

13:40

some of our best-trained new

13:42

specialists can't get jobs here.

13:45

So on the one hand, we've got an

13:47

empty, brand new hospital that

13:49

has delayed opening. And one

13:52

of the reasons is because

13:54

it doesn't have enough staff. On the other

13:56

hand, we're hearing about top-level

14:00

specialist surgeons who can't get work.

14:02

And it's sort of crazy isn't

14:04

it and the organisation that represents

14:07

all those surgeons says it comes

14:09

down to planning that they're saying

14:11

Cefatu Ora needs to be working

14:16

out how many surgeons it needs in

14:18

the future because these specialist general surgeons,

14:20

it takes a few years to train

14:22

them. So they start off and there

14:24

might be lots of demand

14:26

for specialist general surgeons

14:28

in the system but by the time

14:30

their five years are done then there

14:32

are fewer needed. So what

14:35

they are saying is there

14:37

needs to be planning so that we know when

14:39

we come out, when we've finished our training that

14:42

there are jobs for us. Cefatu

14:44

Ora says it's working on it, it says

14:46

it is trying to come up with a

14:48

plan, it's part of it. Remit

14:52

as this new organisation, well

14:54

nearly two years old organisation now that we're

14:56

bringing in all these different district health boards

14:59

into one system and now it's trying to

15:01

come up with a national plan to

15:04

do that but the surgeons are saying

15:06

it needs to happen faster, we need

15:08

clarity otherwise we're losing all these

15:10

brilliant new specialist general

15:13

surgeons to oversee. And

15:15

what is the response from Cefatu Ora

15:18

to that? They are saying that they

15:20

want to keep them, that they value

15:22

them and that they are working on

15:24

getting a workforce plan together

15:27

to try to keep them. The

15:29

Prime Minister's response when this

15:31

was raised about the hospital

15:34

here is it's

15:36

utterly disappointing. That's why

15:38

you've seen us announce a third medical school, that's

15:40

why you've seen us say make sure we've got

15:42

medical staff on the green list for rapid importation

15:45

of staff of immigrants into New Zealand. We've

15:47

done a lot of things in the health space already, there's

15:49

a lot more for us to do. And

15:51

the Labor Party says the government's been

15:54

sitting on its hands. A

15:56

specific plan that needs to be made

15:58

for this hospital and it's troubling. that

16:00

a pathway to getting this hospital

16:02

open with the staff that needs

16:04

in place hasn't been put

16:06

forward. Is that true? Well

16:10

it depends who you talk to. Like some of

16:12

the doctors I've spoken to have

16:14

thought some of the blame does lie with

16:17

labour, that the

16:19

planning for this could have

16:21

been started under their watch

16:24

but other people are saying that it's in

16:26

the government's hands now

16:28

with Tefatu order under them.

16:31

Shane Recy, the health minister, says it's a

16:34

priority for him. He says that he's getting

16:36

weekly updates on it. He wants to see

16:38

it up and running but of course

16:40

it takes money to get it up and

16:42

running and this is

16:44

a government that's talking about cutting

16:47

back on public service spending so

16:49

it's going to be really interesting

16:51

to see when the health budget

16:53

comes out next month, whether this

16:55

is specifically mentioned, where the buildings

16:58

are specifically mentioned, the kind of

17:00

spending that is allocated for the

17:02

health system in general. It doesn't

17:04

instill much confidence in the

17:06

public in the state of our health

17:09

system. You know that I mean

17:11

there have been complaints for years and years and years

17:13

of these long long queues

17:16

that we don't have enough nurses

17:18

that we're losing them to places

17:20

like Australia. Well apparently the nursing

17:22

is improving so we have had

17:25

about 2,000 new nurses

17:27

in the last year or so

17:29

so when you talk to people in the sector

17:32

they say yes we are still short of nurses

17:34

but the situation is improving

17:36

there and aesthetics techs are

17:38

still a big problem. They are the people

17:41

who run all the equipment in your operation

17:43

so the anaesthetist is the doctor that's checking

17:46

that you're asleep and you know administering all

17:48

the medicine but all that technical equipment is

17:51

run by technicians and there's a big shortage

17:53

of them that's really important. It

17:55

is a worldwide problem as

17:57

you probably have heard our government.

18:00

and our health officials say they're competing

18:02

on a worldwide market. But

18:05

yeah it is hard to

18:07

see how these huge waiting lists

18:09

that we've got for surgery will

18:12

be cleared anytime soon when there's buildings

18:14

like this that are empty and when

18:16

we're still struggling to get staff to

18:18

do that work. It is going to

18:20

open. It is going to open isn't it?

18:23

By all intents and purposes it's going to open. I mean

18:25

it is going to open it would be crazy if

18:27

it didn't. It's an expensive

18:29

building, it's good to go, it's

18:31

needed, it will open. They're

18:34

hoping also actually that when it does

18:36

that these ward beds, so

18:38

there are ward beds

18:40

dedicated to surgery and that people will

18:42

stay in after the operations. But there's

18:44

also going to be two wards here

18:47

that are medical wards for people who

18:49

are non-surgical patients and you

18:51

might have heard in the news about

18:53

emergency departments around the country how they

18:55

are chocka chocka block. This

18:58

one here at North Shore just about

19:00

two or three minutes walk from the

19:02

back door of the hospital.

19:16

So Rowan when I was

19:18

scouting around looking at stories about Tauta

19:36

Rahu Maru, there

19:39

was an interview that Tim

19:41

Edmond from the Well Foundation

19:44

did on 9 to 9 late

19:47

last year. The Well Foundation

19:49

is raising millions towards this

19:51

project. One of the

19:53

things that they are raising

19:56

money or they've been raising money for is

19:58

something called a healing garden. You

20:00

are going to walk into this expanse of three

20:03

stories high, so 400 square metres, yes

20:06

but three stories high and there is an evidence

20:08

base that shows that it can reduce the levels

20:10

of pain and stress and that by doing that

20:13

you boost your immune system in ways that

20:15

allow your body and other treatments to help

20:17

you heal. Yeah it's a lovely

20:19

thought that inside this building there would be

20:21

greenery and we can see around the outside

20:23

of it here that there are,

20:26

there's planting it hasn't sort of

20:28

settled in yet but and

20:30

there's all these old pore hicakawa trees near

20:32

where we're standing that are around the outside

20:34

of the hospital but yeah inside there's going

20:36

to be sort of an atrium with a

20:38

lovely garden there that's supposed to be bringing

20:41

in the healing property of nature to people

20:43

who are there and you know hospitals are

20:45

normally a very stark and

20:48

clinical environment so it's

20:51

the sense that people have some of the

20:53

good energy I guess that they get some

20:55

plants. What's happening to that I don't

20:58

know. That's

21:00

it for today, I'm Sharon Brekkele,

21:02

the detail is supported by RNZ

21:04

and NZ On Air. Phil Benj

21:07

engineered this episode, Alexia Russell and

21:09

Davina Zimmer produced it and thanks

21:11

to Rowan Quinn, Ma Piawa.