Harmeet Sokhi was Heather Bills’ primary nurse at Middlemore Hospital for the majority of the six weeks the 64-year-old was treated for burns following a fire at her Orakei home.

Last month, following an inquest in September, Chief Coroner Judge Deborah Marshall ruled the death of Bills, who died from a massive insulin overdose, was no accident.

As part of her findings, Judge Marshall also imposed an interim name suppression order for Sokhi after she made an application for permanent name suppression.

Sokhi argued that publication of her name in association with the findings would infringe upon her character as a person and reputation as a nurse.

However, media organisations, including the Herald, and Bills’ daughter Michelle Maher opposed the application on the grounds of freedom of expression and freedom of the press.

Judge Marshall ruled in favour of the press and Maher, allowing the publication of Sokhi’s name after the interim suppression order lapsed late last Friday.

“The public have a right to be satisfied that vulnerable patients will be subject to a high standard of care in public hospitals,” Judge Marshall said.

“This means that the spotlight will turn on health professionals on occasions.”

Sokhi is still a nurse in the Counties Manukau DHB, and had been working in Middlemore’s intensive care unit following Bills’ death.

However, a doctor’s letter provided to Judge Marshall shows she is currently not working due to distress caused by the inquest.

Following Bills’ death on January 2, 2013 it was discovered that she suffered a suspicious and massive hypoglycaemia-related cerebral injury.

Her death was due to an overdose of insulin being “introduced to her body from the outside”.

Police suspected three medical workers, including Sokhi, of administering the fatal dose to Bills on the night of December 26-27, 2012.

The other two were healthcare assistants, Sharon Connors and Nirmala Salim.

Bills was not diabetic and had not been prescribed insulin at the time of her death.

Detective Senior Sergeant Ross Ellwood, the officer in charge of the criminal case, told the Herald after the inquest’s findings were released that police would be reviewing the findings and the police investigation.

“This is expected to take some time,” he said.

To date, no one has been charged in relation to Bills’ death.

However, during the inquest Ellwood expressed his views and said Bills’ death was the first and only one of its kind in New Zealand.

“I have my own view as to whether [Bills] was injected or not, but my view is not important, it’s what I can prove in court,” he said.

“I think she was injected. We’re looking at someone working in a hospital, potentially causing the death of a patient, and we can’t have that.”

Judge Marshall’s findings ruled that Bills had limited mobility, supporting a view that “the insulin must have either been handed to her or administered to her”.

“She could not get out of bed to source insulin herself,” she said.

“It appears from the evidence that opening a vial and preparing an injection would have been beyond her abilities but she may have been able to inject insulin if it was given to her.

“It is not possible from the evidence to say whether the insulin was administered by injection or intravenously.”

Judge Marshall said she was satisfied Bills was administered an overdose.

“And that the overdose must have been administered by someone who had access to insulin and the secure National Burns Centre,” she said.

“The cause of death was a non-accidental overdose of insulin.”

Bills had been pulled from the house fire during the evening of November 22, 2012, when neighbours braved the inferno to rescue her from an upstairs room of her home.

The fire was deliberately lit and she suffered burns to 35 per cent of her body.

While in hospital, Bills displayed suicidal thoughts and offered nurses cash to help her die, the inquest heard.

She was then treated at the burns centre and intensive care (ICU) as her condition improved at Middlemore.

But Bills’ health rapidly deteriorated on the night of December 26-27, confusing doctors who were “inattentionally blind” to the insulin killing her.

Maher said at the inquest that her mother had suffered a long and difficult mental illness, and wanted answers about her death.

She said her mother did not deserve to die in hospital in the way she did and her family deserved the right to know the causes and circumstances surrounding her death.

The email reveals “ground zero” pressures on the South Auckland hospital and details strategies for staff to clear beds and get patients out.

It has brought a concession from management at Counties Manukau District Health Board that staff are under pressure and have raised concerns about “staffing and capacity”.

Despite this, Health Minister Jonathan Coleman said in a statement: “This isn’t unusual for this time of year, and the reality is that the hospital can cope.”

The pressure at Middlemore Hospital was revealed last month when it emerged staff had created a sign urging patients to go elsewhere or face waiting eight hours in the Emergency Department.

While the sign was removed after management learned of it, the NZ Herald has since found it had been used on a number of occasions for at least eight weeks.

The internal email – provided to Labour’s Mangere MP Aupito Su’a William Sio – showed the extent of the pressure placed on the South Auckland hospital, and how those issues existed beyond the Emergency Department.

The memo told staff the total hospital occupancy was at 104 per cent and stated: “The hospital is full.”

Other areas of the hospital were stretched even further, with medicine and surgical areas at 116 per cent capacity.

The memo detailed coping strategies, telling staff to get people into the “discharge lounge as soon as possible” to help move patients from the Emergency Department.

It stated that there had been 355 patients through the Emergency Department the previous day and there were still 119 patients there.

The Emergency Care section had 45 patients waiting for a hospital bed while the 12 operating theatres had 50 people waiting for surgery.

Staff were told: “We need a total of 58 beds before today’s patients arrive.”

Sio told the NZ Herald he believed the pressures on the Emergency Department were – in part – a reflection of the scarcity of money for doctor’s visits among families in South Auckland.

He said those in Middlemore Hospital’s area were “working class” people who had little to spare after rent, power and food.

“They won’t go to the doctors because there’s a charge so go to the A&E because it’s free. That hospital just isn’t coping.”

Sio said doctor’s fees of $20 or more was a “big chunk” out of a family’s budget. “And it’s not just the doctor’s fee, it’s the medicine.”

Sio’s own family experienced a lengthy delay at the Emergency Department in May when his father Aupito Pupu Lolesio, 79, waited 10 hours for an x-ray after suffering a cut to the face.

A spokeswoman for the health board said August had been “particularly busy” with illness among not only among the community but those working at the hospital, which had made staffing difficult.

“We encourage our staff to report their concerns so that we are able to respond where possible.

“Our staff have raised with us (through internal reporting and through their unions) concerns about staffing and capacity – particularly recently during winter.”

The spokeswoman said the health board’s planning for winter used data from the previous year to predict the numbers of patients. “This year an additional 40 beds were included for winter planning.”

The expected winter increase came early in mid-May meaning the extra beds were started early and kept available.

She said the “hospital full” memo was sent on “extremely busy days” when Middlemore Hospital started with “a full hospital, a full Emergency Department and patients already waiting for a bed before the next wave of patients arrive”.

It was sent out across the hospital “letting them know that everyone needs to help”.

Coleman said there had been a “sustained rise” in demand across the region which “isn’t unusual” for winter and the hospital could manage.

He said the current occupancy was 98.6 per cent and “there are pressures that hard-working staff are dealing with”.

Coleman said those with illnesses that could be managed by their family doctor should seek care there.

He said National had supported GP visits with free care for those aged under 13, a low-cost scheme and expansion of the Community Services Card capping doctor visits at $18 for 600,000 New Zealanders.

“These policies mean around half of all New Zealanders have either free or cheap doctor’s visits.”