Treatment of hospital assault ‘epidemic’ ends prompting reinfection concerns

Line of Defence Magazine - Autumn 2024

ED Security
Funding for ED security treatment ends.

Government’s $5.7 million summer boost to emergency department security comes to an end, prompting concerns from doctors and hospital workers that violence will return.

Announcing the ED security boost, Health Minister Shane Reti cited alarming increases in violent incidents in hospitals “In 2021, HNZ reported 1,179 assaults, rising to 3,459 in 2022,” he said. “In the first three months of 2023, 1,267 assaults were reported.”

“That’s why we’ve committed to these additional workers to help keep patients – and our hard-working doctors, nurses and other ED staff – safe during a particularly busy time,” he said on 22 December.

“This initiative addresses an immediate need. I’m also committed to working urgently on a longer-term plan to improve security across our hospitals.”

Dr Shane Reti

As part of the government’s 100-day plan initiative, eight higher risk emergency departments in Auckland, Waikato, Wellington, Christchurch, and Dunedin each received an additional five security staff until the end of February.

A further 24 emergency departments near summer hotspots each received between two and five additional security staff to help manage pressures over the summer holiday peak.

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According to a February 2023 report by APEX, the union for allied, scientific and technical employees in New Zealand, overseas data suggests health care workers make up 50% of the victims of workplace assault. It’s a problem, states APEX, “driven in part by societal changes, and in part by increasing pressure and short staffing, [which] is increasingly being labelled an “epidemic” in its own right.”

But it’s by no means a recent epidemic. According to the report, a 2011 study on workplace violence by Massey University of over 96 organisations representing over 76,000 employees found that “health was the industry with the highest rate of violence – reporting 55.3 cases of assault per 1000 employees, twice as bad as construction and nearly nine times worse than manufacturing.”

“This initiative addresses an immediate need,” Dr Reti said. “I’m also committed to working urgently on a longer-term plan to improve security across our hospitals.”

According to One News, Australasian College for Emergency Medicine Aotearoa New Zealand chair Dr Kate Allan said she had heard “a range of feedback” on the initiative from emergency departments. Some reported that some security staff did not seem to be appropriately trained, integrated, or supported.

“Other doctors reported that their emergency departments did not receive any security, leaving staff feeling ‘unsafe and unsupported’,” she said. “Other colleagues reported that the presence of extra security reduced instances of verbal abuse, and ‘kept a lid’ on things after violent incidents.”

With reductions in incidents reported over the Summer, Allan said the feedback indicated the programme worked. She wants every emergency department in New Zealand to have carefully selected security staff who are culturally aware and skilled in de-escalation techniques 24/7.

But the government’s $5.7 million in funding ended on 29 February, worrying doctors and hospital workers.

Te Whatu Ora says that between now and 01 July is reallocating money from other projects to fund security guards for hospitals while it reviews the programme, but it will mean fewer guards.