Health bosses are vowing to get their act together after Waikato Hospital emergency department was ranked New Zealand's least efficient.
New rankings of the country's 20 district health boards have Waikato DHB placed last - along with Capital and Coast DHB - in achieving the nationally prescribed target of 95 per cent of admissions being seen within six hours.
Meanwhile one Waikato women is fuming that vomiting drunks appeared to receive treatment before her husband, who was suffering a suspected neck injury.
The DHB was able to admit, discharge or transfer patients in 88 per cent of cases, meaning up to 10 patients a day were left waiting more than six hours for treatment.
Yesterday DHB officials attributed the results for the last quarter of 2012 to a number of factors, including emergency department understaffing, an 11 per cent increase in admissions over the past year and a lack of available beds - particularly single pediatric beds.
Group manager of Waikato and Thames hospitals Mark Spittal described the ranking as extremely disappointing.
"We are not happy with the performance of the hospital . . . we have been working extremely hard on this because ultimately it is about the service that we provide to people who need care here."
However, the news is of no comfort to Te Pahu couple Stuart and Julie Hopkins.
Mr Hopkins, 42, suffered head injuries and a concussion after an accident on Sunday.
After an initial consultation with Anglesea Hospital in Hamilton suggested a possible serious spinal injury, he was rushed by ambulance to Waikato emergency department, where he was forced to wait more than eight hours for assessment.
Mrs Hopkins, who waited alongside her husband from about 5.30pm until they saw a doctor at about 2am, said she was not surprised to hear Waikato DHB had ranked last.
"The thing that concerned us was that it was a spinal injury.
"We had done what we had been told to do and gone to another emergency department before we came to Waikato . . . and when we were transferred by ambulance on a back board we still had to wait eight hours."
Although a CT scan at about 4am revealed Mr Hopkins' injuries to be less serious than initially thought, he said he was very concerned about whether he would sustain further damage to his spine because of the slow assessment.
The Waikato DHB has never been last in the six-hour health targets tables since they began in 2009/10.
But a five-place slip in a year has left hospital management unimpressed.
Mr Spittal said the single biggest issue the DHB was focussing on was how to work with GPs to reduce demand.
He said initiatives with primary care, most notably work with Midlands Health Network on the primary options for the acute care programme were aimed at providing GPs with alternatives to sending people to emergency departments.
Patient admissions to the emergency department for relatively minor issues were putting a strain on resources, too.
"There are some patients, particularly at weekends, that come with relatively minor conditions," Dr John Bonning, emergency department clinical director at Waikato Hospital said.
Some of that, judging by the Hopkins experience, was alcohol related.
Mrs Hopkins said drunk people - some vomiting - were seen before her husband at the weekend.
"We were told because Stuart's injuries were not critical, they had to deal with these drunk people first.
"It was extremely frustrating and very unsatisfactory."
On top of increased demand on emergency department services, a lack of specialist medical staff, especially on weekends, was noted as a big factor in the health target rankings.
Hospital officials believe the provision of additional funding to the hospital, which will result in the number of full time emergency department specialists bumped up from 11 to 15 by March, will ease the burden on current staff.
Recruiting specialists to the emergency department also seemed difficult, with the DHB having to look as far as the US for staff, Dr Bonning said.
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