ACEM Response To The 2023 Aotearoa New Zealand Budget

The Aotearoa New Zealand faculty of the Australasian College for Emergency Medicine (ACEM; the College) welcomes the modest investments in health in the 2023 budget and awaits further details on implementation.

ACEM recently acknowledged Te Whatu Ora’s winter planas pragmatic and practical but drew attention to staffing deficits. Proper implementation of the $99 million allocated to winter 2023 initiatives will be crucial in supporting public health this winter and managing emergency department (ED) presentations and hospital admissions.

ACEM’s Manaaki Mana strategy aims for equity in all Aotearoa New Zealand EDs, and ACEM acknowledges the $20 million allocated, to improve health equity for Māori and Pacific peoples, as a step in the right direction.

A lack of accessible, affordable, and coordinated primary and community-based care over time, including access to prescription medication, can contribute to pressures on EDs. The College hopes that the $618.6 million investment towards the removal of the $5 prescription fee will help reduce low acuity presentations to ED, and ensure more people get the care they need, faster.

However, these positive measures will not address the main problem facing EDs.Bed block – where patients get stuck in ED, while waiting to move to their next place of care – is the root cause of ED overcrowding and overly long waits for care. Solutions are complex but must include investments in disability services, hospital beds – including mental health – and in residential aged care beds.

To that end, the College welcomes the $863.6 million allocated to support tāngata whaikaha and disabled people, and their whānau, carers and supporters. Having robust, accessible systems and resources in the community can help people get the care they need locally and reduce pressures on EDs.

The $118m allocated to “reduce waiting lists by freeing up inpatient hospital beds”, if appropriately implemented, could provide small improvements to bed block, but is nowhere near the size of the investment needed to see real change.

The College is calling for all parties contesting the 2023 election to work with healthcare workers on plans that lead to more staffed ED-accessible hospital beds, and considerably more residential aged-care beds.

ACEM has also called on the Government, Te Whatu Ora, hospital administrators and all people involved in the operations of healthcare and hospital systems to work with healthcare workers to ensure emergency departments are safer, for all staff, patients, and whānau.

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