The crisis in our EDs must be an immediate priority for our country’s leaders. The Australasian College for Emergency Medicine (ACEM; the College) is urging whoever forms government to commit to specific, funded policies that address the critical burden on emergency medicine specialists and patients.
ACEM's State of Emergency report, launched in September, provides evidence-based recommendations to alleviate ED pressures and improve health outcomes. These options included increasing and sustaining investment in inpatient and aged care capacity, supporting initiatives to grow the emergency specialist workforce, and improving Māori health equity through cultural safety training and performance frameworks that are aligned with Te Tiriti o Waitangi obligations.
Six weeks on, while political parties have announced some policies — such as Labour releasing its emergency recovery package and National pledging to establish a steering group for aged care reform — the College is yet to see firm, funded commitments from any of the parties that include safe, timely emergency care as part of overarching healthcare reforms.
"Moving forward we will need to hear specific, funded policy proposals that benefit and address the needs of our ED patients and staff,” ACEM Aotearoa New Zealand Council Chair Dr Michael Connelly said.
"With current resourcing, our EDs and health system are not keeping pace with rising patient demand, including an increase in more high-acuity, complex care needs. Overwhelming ED pressure is a patient safety issue. The evidence is clear that longer waits in the ED increase the risk of patients deteriorating and dying.”
ACEM’s State of Emergency report found that:
- EDs saw a record 1.4 million presentations in 2024-25, a 21 per cent increase since 2015-16, far exceeding the 13 per cent growth in population over the same period.
- Māori patients attending the ED rose by 39 per cent in this time — almost double the overall ED growth rate.
- Two in three patients are now triaged into the most urgent categories, up from just over one in two patients half a decade ago.
- Over the past decade hospital bed numbers have fallen from 2.7 to 2.5 per 1000 people, leaving patients stuck in EDs and, increasingly, cared for in corridors.
Dr Connelly said that EDs bear the brunt of widespread health system failures including longstanding underinvestment in inpatient capacity, workforce, aged care, primary care and community supports.
“We need a well-resourced and coordinated health system with enough beds, staff, and support beyond the ED. Whole-of-health system reform and investment is essential as it would enable us to deliver safe, timely, high-quality care for everyone.”
ACEM wants the next government to commit to changes which will:
- Increase inpatient bed capacity across the hospital system, including addressing access block.
- Grow and retain the emergency medicine specialist workforce, particularly in regional and rural communities.
- Expand community and aged care support so older patients who are medically ready for discharge can leave the hospital without delay with the care and support they need.
- Reduce persistent Māori health inequities across emergency care, primary and community care.
"ACEM is ready to work with whoever forms the government to build a stronger, more sustainable health system for Aotearoa New Zealand,” Dr Connelly said. “Our State of Emergency report provides the evidence base and direction for meaningful and enduring change. The time to act is now."
Download ACEM’s State of Emergency here.
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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