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Summary of Report
The capacity of emergency and health services to cope with terrorist events gained world attention through the attacks on the World Trade Centre in 2001, the Bali bombings in 2002 and the Madrid bombings in 2004. The prospects of a terrorist event assumed a highly local focus in 2003 with threats to the staging of the America’s Cup in Auckland, the New Zealand Golf Open in Wellington and foreign embassies. Over the same period, the emergence of Severe Acute Respiratory Syndrome and Avian Flu within the region emphasised the threats posed to New Zealand by communicable diseases more easily spread through more accessible and affordable international air travel.
Study Objectives and Scope
The objectives of the study were to:
- Assess the NZ health sectors capacity to respond to unusual/serious health emergencies;
- Provide advice on options to address gaps in capacity; and
- Conduct a high-level cost benefit analysis of the identified options.
The scope of the study included critical equipment, supplies and facilities, numbers of available health professionals, emergency response procedures and training.
Critical Vulnerabilities
National level
- a lack of clearly defined accountabilities and responsibilities for health sector emergency management preparedness in national legislation;
- inadequate policy coverage on key areas of emergency management preparedness;
- lack of proven structures and processes for coordinating a national response to an emergency
and for engaging the health sector in that response; and - a communications and information infrastructure that does not provide the critical national information required to ensure an effective and coordinated national response.
Regional level
- a culture of competition between District Health Boards;
- a lack of alignment of health and other government boundaries;
- a lack of clearly defined accountabilities and responsibilities for health sector emergency management preparedness;
- a lack of proven structures and processes for coordinating a regional response to an emergency and for engaging the wider regional health sector in that response;
- a lack of effective regional level health intelligence and health surveillance processes; and
- a lack of regular exercising of regional health response capabilities.
Delivery level
- variable commitment to emergency management preparedness at senior management level;
- inadequate targeted funding for District Health Boards to build preparedness;
- a lack of effective engagement with the wider health sector in emergency management preparedness, particularly primary care;
- a shortfall of patient evacuation and transportation assets – road and air;
- limited workforce capacity in areas like ambulance paramedics, emergency department and intensive care unit staff;
- a lack of effective arrangements to generate a surge in local health service delivery capacity by utilising regional and national resources;
- a lack of effective policies and protocols for protection of the health workforce;
- limited emergency management expertise, and particularly personnel trained in the Coordinated Incident Management System;
- a shortage of expertise in critical areas like infection control and the clinical care of chemical, biological or radiological casualties;
- a lack of standard clinical protocols for the treatment of chemical, biological or radiological casualties;
- a lack of full-time emergency management preparedness staff at District Health Boards;
- limited availability and stocks of personal protective equipment;
- limited availability of critical equipments, eg ventilators;
- limited availability of isolation and negative pressure treatment facilities;
- a lack of facilities for mass assessment of casualties; and
- limited availability of decontamination facilities.
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