shortages of staff and beds are putting emergency departments nationwide in near-permanent crisis mode. The government says change is coming – but staff say they need help now, writes Catherine McGregor in today’s excerpt from The Bulletin.
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Assaults on Auckland hospital staff skyrocket
The emergency department crisis is increasingly being measured not just in wait times, but in violence. The Post’s Harriet Laughton (paywalled) reports on data showing reported assaults on Auckland hospital workers more than tripled in two years – from 371 in 2022 to 1170 in 2024 – with incidents requiring time off work also climbing sharply.
While Health NZ says the rise is mainly down to improved reporting, nurses say it reflects boiling frustration in overcrowded EDs, fuelled by chronic understaffing and hours-long waits. NZNO Primary Health Care College chair Tracey Morgan said the abuse felt “uncontrollable” and she no longer felt safe at work. A Waikato ED nurse recalled being punched through a gap in the glass by a patient who had waited hours with a broken bone, with security failing to intervene. Health minister Simeon Brown said violence in EDs is “completely unacceptable”, but noted that the situation has improved since the period in question following a $31m boost for ED security in Budget 2024.
Wellington’s code reds ‘the majority of the day’
Further south, the situation is just as combustible. Last month Laughton and her colleague Tom Hunt reported on OIA data revealing Wellington Hospital’s emergency department hit “code red” – the most critical overload status – 575 times between January and October last year, or almost twice a day on average. In 2024, the hospital did not enter code red once. Staff say the reality is even bleaker than those figures suggest. “We are in code red the majority of the 24 hours,” one NZNO delegate said, describing elderly patients stuck in hallways and people waiting a day or more for a ward bed.
That pressure was on full view on January 20, when the ED went into code red four times in five hours. Stuff’s Laura Frykberg spoke to a patient who described nurses, doctors and even security guards “in tears” and an elderly woman who had waited nine hours saying, “this isn’t how I wanted to die”. Health NZ said demand that night was at the “higher end of normal” and escalation processes were in place. But a nurse said the shift was “absolutely horrible” – though not that unusual. “We are always in a code red situation, we are never out of it really. As nurses we just learn to get on and do the job, we are regularly abused,” she said.
Christchurch, Hawke’s Bay, and everywhere else
Wellington is not alone. OIA data reported on by Joanne Naish of The Press and Nikki Macdonald of The Post (paywalled) shows Christchurch ED recorded code reds on nearly a third of days last winter, while Hawke’s Bay recorded 162 days of critical overload in 2024 – almost half the year. Doctors warn that without urgent fixes, code reds will become more and more routine.
The health minister told The Post that the situation at Wellington ED “is not good enough”, while a spokesperson said ED performance nationally had “deteriorated significantly” under Labour. This government is spending $100 million on 21 separate fast-track hospital infrastructure improvements, including for specific EDs. Work on a new Wellington ED is scheduled to start in 2027 for an expected opening in 2029.
What a code red really means – and what changed
A code red is the final step in a traffic-light escalation system, triggered when demand overwhelms available staff and beds. It can mean delayed medication, patients sleeping on trolleys, postponed procedures and even an increased risk of death if patients wait longer than five hours.
As RNZ’s Ruth Hill reported, in 2024 Health NZ quietly scrapped “code black” – the highest alert previously used by some EDs – and raised the thresholds for code red, meaning conditions had to be worse before escalation was formally triggered. One emergency doctor said it was “just moving the goalposts”, making overcrowding look better on paper while leaving the situation on the frontline unchanged. Health NZ said the change was made to achieve nationwide consistency and improve data quality. But for staff rushing between five or six patients at once, the colour of the alert matters less than what it represents: a system stretched so thin that crisis has become routine.
