ACEM response to New Zealand Government budget

The Australasian College for Emergency Medicine (ACEM, the College) welcomes the strong focus on health in the budget handed down by the Aotearoa New Zealand Government today, as we continue to confront the COVID-19 pandemic.

ACEM President Dr John Bonning said: “The coronavirus has strongly reinforced the importance of having a robust, well-supported and sustainable public health system. We acknowledge and appreciate the significant ongoing funding commitment announced by the government in this budget.”

“As we continue to contend with the challenges presented by COVID-19 and gradually emerge from stringent lockdown arrangements, we must learn from the lessons and experiences gained during the planning and response effort. In particular we refer to the strong levels of co-operation and collaboration which have occurred across our whole health system.

“A priority must be, avoiding a return to the chronic access block and emergency department (ED) overcrowding so common prior to COVID-19. What we don’t want to see further down the track as we continue coming to terms with our new normal, is emergency departments becoming dangerously overcrowded once again, be it as a result of attitudinal, fiscal or systemic reasons.

“The whole of hospital and community healthcare systems must work effectively so patients are not stranded in corridors in EDs, in crowded waiting rooms, unable to reach their care destination or ward. There has never been a more important time for us to choose wisely, and rationally use our precious healthcare resources for those with the greatest need.

“As always, the College stands ready to continue working with the government to ensure the focus remains on New Zealanders having ongoing access to an accessible, equitable, high-quality and safe healthcare system.”

Mental health

“Another important component, as we confront the new normal in our hospitals, healthcare systems and communities, is maintaining a focus on mental health care. ACEM has long been outspoken that emergency departments are seeing an increasing number of patients with acute mental and behavioural conditions across all age groups.

“Following last year’s ‘Wellbeing Budget’, ACEM welcomed and supported the government’s strong investment and focus on specific mental health initiatives and services. In light of additional funding announced for District Health Boards (DHB) in this year’s budget, ACEM emphasises that the focus on improving mental health services must remain a key priority for the health system and government.

“The stresses associated with the COVID-19 pandemic will continue to present a new set of significant and complex mental health challenges. Even with improved prevention and community support services, EDs will continue to have a core role in supporting people in psychological distress, particularly during and after the COVID-19 pandemic.

“Whilst many locations have experienced a temporary downturn in ED presentations in general, our members across Aotearoa New Zealand and Australia tell us that mental health presentations have continued at similar rates to those pre-COVID-19 and are surging in some areas. We also have concerns that the decreased up-take of community mental health services during COVID-19 may result in more mental health presentations to EDs in the coming months.

“While measures are needed to provide patients experiencing mental health crisis with options other than the ED, EDs must also be properly resourced to cope with existing and future demand and address dangerously long waits for patients.

“It is now more important than ever to embed the principles of Te Tiriti o Waitangi to address widening inequitable health outcomes. Māori need to have more input into how the system is set up to meet their needs, which includes broader conversations about the types of support offered to Māori and how it is governed, funded, designed, and delivered.”

In June last year following its Mental Health in Aotearoa New Zealand Emergency Department Summit, the College issued a communique outlining nine key principles for mental health care.

ACEM New Zealand Faculty Chair Dr André Cromhout said: “In light of the historic underfunding of hospitals in Aotearoa New Zealand, we welcome and acknowledge the significant additional investment of $980 million per year for District Health Boards (DHB) outlined in this year’s budget.”

“The government’s one-off investment of $282.5 million, over three years, to help address any backlog of care, such as elective surgery, which may have been delayed during early stages of the COVID-19 response is also heartening.

“An important part of efforts to ensure we do not return to chronic access block and overcrowded emergency departments is positioning ourselves to meet any potential surge of unmet healthcare needs presenting to our hospitals and emergency departments. To this end, it is crucially important that the spirit of collaboration and co-operation across our hospitals and health systems, which has characterised so much of our response to COVID-19, is maintained.

“While the additional funding is encouraging, as always it is crucial that this funding is supported with clinical engagement with frontline emergency department staff to achieve the objective of an accessible, equitable, high quality and safe health system. The money needs to be used to enhance frontline services, and must not be tied up in DHB bureaucracies. The views and expertise of emergency physicians must continue to be heard and taken into account across our hospitals, health systems and government.”

Background

ACEM is the peak body for emergency medicine in Aotearoa New Zealand and Australia, responsible for training emergency physicians and advancement of professional standards. www.acem.org.au

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