The country's first-ever State of Emergency (SoE) report draws on a decade of national ED data and the perspectives of emergency medicine specialists across the country. Launched today by the Australasian College for Emergency Medicine (ACEM; the College), it highlights the extreme pressure that hospital ED staff and patients are experiencing.
ACEM is calling on all political parties ahead of the general election to commit to actioning the State of Emergency report's recommendations, including increased and sustained investment in inpatient and aged care capacity, supporting initiatives to grow our emergency specialist workforce, improving Māori health equity through cultural safety training and ensuring health budgets and performance frameworks are aligned with Te Tiriti o Waitangi obligations.
"This report is a reality check and a call to action," ACEM Aotearoa New Zealand Council Chair Dr Michael Connelly said. "We want to see emergency care front and centre of every party's health policy."
"Our health system is in crisis. Our EDs are operating at or above capacity every day. That is not sustainable for our workforce or our patients, who continue to face longer wait times for the care they need.
“ACEM’s State of Emergency report reveals the growing challenges we face in managing rising patient demand and confirms we urgently need increased, sustained investment across the entire health system, including inpatient capacity and residential aged care supports.”
Among the findings were:
- EDs saw a record 1.4 million patients in 2024-25, a 21 per cent increase over the past decade, far exceeding the 13 per cent growth in population during the same period.
- There has been a significant rise of acutely unwell patients coming to the ED requiring urgent complex emergency care and hospital admission.
- Māori patients attending the ED rose by 39 per cent in this time — almost double the overall ED growth rate.
The College’s report presents regional ‘snapshots’ and sets out evidence-based recommendations for targeted systemic reform and increased resourcing across three priority areas: patient access and flow, workforce sustainability, and Māori health equity.
“More of us are living longer, with more complex health needs and many of us need an inpatient hospital bed, not just the emergency department," Dr Connelly said. "We see the result of that every day, with patients stuck in our EDs because there's nowhere upstairs to send them, and the flow through the entire hospital is backed up.”
The report finds that a workforce capacity shortage is putting additional strain on EDs, making it harder to meet patient demand.
“Where you live shouldn't decide how quickly you see a doctor. We need real investment in training and supporting emergency doctors throughout Aotearoa New Zealand, including in regional and rural communities.”
The report also shows that the system is failing Māori, with persistent health inequities, including a greater proportion of Māori patients coming to the ED acutely unwell.
“Health inequity for Māori is a longstanding systemic failure, which includes barriers to accessing primary and community care," Dr Connelly said.
The College is committed to improving Māori health equity in EDs through its strategy Te Rautaki Manaaki Mana: Excellence in Emergency Care for Māori 2026-2029, he said. “But further gains also lie outside of the ED, and solutions must be system wide.”
"Emergency departments and staff provide care 24/7 for everyone. But the intense, constant pressure EDs are under is not sustainable. We need a well-resourced and coordinated health system with enough beds, staff, and support beyond the ED to provide safe, timely, high-quality care for everyone,” Dr Connelly said.
“The challenges we face need whole-of-health system solutions to respond to rising demand and the healthcare needs of our communities. The time to act is now.”
ACEM will publicly support pre-electoral pledges that align with the report’s recommendations and encourages political parties to work constructively with emergency doctors for a healthier Aotearoa New Zealand.
Read State of Emergency, ACEM's first report of its kind for Aotearoa New Zealand, 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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