'It shouldn't have come to this': Union hits out at Starship cancer treatment delays

The nurses union says nearly half of shifts on Starship children’s hospital’s oncology ward were below safe staffing levels this year, and health bosses should have hired more nurses rather than delaying cancer treatment for sick kids.

“It shouldn’t have come to this,” New Zealand Nurses Organisation (NZNO) president Kerri Nuku said.

“Health Minister Simeon Brown can argue oncology services are being postponed and not suspended, but such semantics are unlikely to be important to whānau with children with cancer.”

The Herald today revealed that because of nursing shortages and high demand at Starship’s paediatric haematology/oncology service, some cancer treatments had been “rescheduled”.

A source told the Herald that staff were horrified to learn of the developments last week and management was “terrified” about the information leaking out.

Brown has now asked Health New Zealand chief executive Dale Bramley for an explanation after being alerted to the delays by the Herald.

In a statement, Brown confirmed “a handful” of chemotherapy sessions had been delayed by up to seven days.

Two bone marrow transplants had been “moved slightly” from their original dates.

Brown said the hospital was managing demand and winter pressures as usual, and clinical teams were involved in the decisions.

He also hit back at claims from a Starship nurse that child cancer treatment had been “suspended”, saying the suggestion was wrong.

Meanwhile, another Starship source told the Herald understaffing was causing severe pressure in the oncology ward, which they claimed had resulted in several clinical errors this year relating to medicines.

The source described what they believed was an “effective sinking lid policy”.

“We’re not allowed to replace people,” they claimed. “We’re down to low numbers. And also, they’re only allowed to hire junior nurses so if an experienced nurse leaves you’re not allowed to get like for like.

“So over time there’s a depletion of clinical knowledge and experience. Those staff are under much more pressure, which can lead to errors.”

The NZNO has now released data obtained under the Official Information Act, which it said showed staff shortages on the oncology ward had worsened this year.

“Te Whatu Ora should have hired more nurses before they were forced to suspend vital cancer treatments for sick children.

“Nurses have been crying out for the past two years about the risk to patient safety being caused by deliberate short staffing.”

Nuku said the data showed 85% of shifts on the ward were understaffed during August.

The number of “shifts below target” had steadily risen since January, when 18% of shifts were understaffed, up to 53% in July, before spiking in August.

“This year alone, 42% of all shifts on the oncology ward ... were below safe staffing levels.”

However, a statement from Brown’s office said Starship nursing vacancies were because of natural attrition. All the vacancies were expected to be filled by December or January.

“Paediatric oncology is highly specialised work, so these roles need nurses with specific skills and experience. Graduate nurses are a valued part of the workforce, but they cannot always simply be placed into complex specialist roles.”

The statement claimed there was no hiring freeze at Health NZ.

‘Decisions not made lightly’

In a statement last night, Health NZ confirmed that because of nursing shortages and high demand in the paediatric haematology/oncology service, some treatments had been “rescheduled”.

“These decisions are not made lightly and are based on clinical need,” Starship director medical and community, Dr Greg Williams, said.

“Patient safety and high-quality care is always our highest priority.

“We want to reassure parents and families that their children will get the clinical care and support they need.”

Williams said as a result of staff shortages, high demand and clinical complexity, some treatments had been rescheduled “to ensure our services can still be delivered safely, within capacity, while remaining within reasonable timeframes”.

Williams said Starship was recruiting experienced and new graduate nurses as quickly as possible.

The nurse who spoke to the Herald said she and other staff were “horrified and appalled” at the postponements, which she said had the potential to adversely affect patient outcomes.

“You’re increasing the risk of complications and death from cancers.”

She said the severe staffing shortage was not simply related to the winter flu spike. It had been critical “all of this year”.

“Over the last year with budget constraints, they’ve not hired new nurses. Anytime a nurse left, they weren’t replaced.”

She was unsure when the postponement of chemo and bone marrow transplants took effect or how many patients were affected – questions the Herald has put to Health NZ.

“It’s so wrong. We shouldn’t not be able to hire staff and we shouldn’t be placing patients at risk by not having staff.

“It’s ridiculous that it’s even happening. You can delay other things without impacting a child’s outcomes.”

Starship children's hospital in Auckland is home to the national child cancer unit. Photo / Michael Craig

Child Cancer Foundation responds

Child Cancer Foundation chief executive Monica Briggs said: “Our hearts are with every child with cancer and their whānau who may be feeling anxious in light of this news. We recognise how incredibly difficult the childhood cancer journey is, even in the best of circumstances and how deeply unsettling any uncertainty around treatment can be for families.”

Briggs said the foundation recognised the extraordinary work of the healthcare professionals who cared for these children and families in increasingly challenging circumstances.

“While clinical decisions and hospital operations sit with health providers, our commitment to families remains unwavering. We will continue to provide practical and emotional support – drawing our families closer at this time.

“Our purpose has always been to ensure no family faces childhood cancer alone. Now, more than ever, we want families to know that we are here, we care deeply, and we will continue walking alongside them every step of the way.”

Lane Nichols is Auckland Desk Editor and a senior journalist for the New Zealand Herald with more than 20 years’ experience in the industry.