The chief emergency doctor of the NT's largest hospital used an awkward New Year's Eve press conference to criticise the Top End's overstretched health system, calling for more beds as a matter of urgency.

His comments came less than 18 months after the opening of a 116-bed, $206 million hospital in Palmerston, a facility just 21 kilometres from the existing Royal Darwin Hospital (RDH).

So what is going on with Darwin's hospitals? How does opening a new facility add more pressure?

As Top End Health Service's emergency medicine director Didier Palmer told media on New Year's Eve, the new Palmerston Regional Hospital (PRH) "created more demand" for staff at RDH.

He said staff were struggling to cope and RDH was in desperate need of more beds.

Top End Health Service executive director medical service, Dr Charles Pain, who oversees both hospitals, explained some of the spike had been caused by people choosing to visit the ED at PRH instead of their regular GP.

Dr Pain said every bed at PRH the facility was full — which clearly demonstrated a need from the community. ( Source: Irwinconsult )

He also said the older facility was experiencing extra pressure because it shared staff with PRH.

But Australian Medical Association NT president Dr Robert Parker said the Palmerston facility was a "total waste of money" — especially considering the NT Government's debt was expected to reach more than $8 billion over the next four years of forward estimates.

"It's a luxury we can't afford at the moment," he said.

Dr Parker said if it was up to him, he'd shut "everything" down at PRH except the rehab and geriatrics ward.

"It really should have been what the original concept was — a rehab, geriatric facility," he said.

"Palmerston will have its day, it will achieve its goals in about 10 to 15 years when RDH has structural issues.

"The building itself is a good idea, but currently it's just absorbing a whole heap of resources."

Space to play or pause, M to mute, left and right arrows to seek, up and down arrows for volume. Watch Duration: 1 minute 26 seconds 1 m 26 s Darwin Hospital faces shortage of emergency beds

Palmerston 'hasn't realised its potential'

Dr Pain said every bed at the PRH facility was full — which clearly demonstrated a need from the community — and by April another 30 beds would open, easing pressure on both RDH and PRH.

"I wouldn't like people to think that the opening of Palmerston has been detrimental," Dr Pain said.

"It's overwhelmingly been a good thing. But it hasn't quite realised it's potential."

The hospital construction cost at least $206 million. ( ABC News: Emilie Gramenz )

Dr Pain said the two services which PRH was delivering well — geriatrics and rehab medicine — had helped many Territorians get back home sooner.

But he didn't agree with Dr Parker's proposal to shut all the other services at PRH.

ACEM figures show: Prior to the opening of PRH ED in August 2018, RDH ED was seeing about 71,000 patients per year

Prior to the opening of PRH ED in August 2018, RDH ED was seeing about 71,000 patients per year Since PRH ED opened, the number of patients RDH ED saw per year decreased to to 61,000

Since PRH ED opened, the number of patients RDH ED saw per year decreased to to 61,000 PRH ED started seeing about 30,000 patients per year

PRH ED started seeing about 30,000 patients per year This accounts to a net increase of 20,000 patients per year

Overall, Dr Pain said there had been a 10 per cent growth in the number of discharges from PRH and RDH in the last year, and patients who presented to the ED were not always admitted to hospital.

According to the Australasian College for Emergency Medicine (ACEM), the number of presentations to RDH and PRH has increased by about 30 per cent since August 2018, when the Palmerston facility opened.

Dr Pain put some of the spike down to patients choosing to visit the PRH ED instead of their GP.

The opening of the new Palmerston facility coincided with a reduction of hours at Palmerston GP Super Clinic, a five-minute drive from PRH.

The Super Clinic used to be open 24 hours a day, but started closing at 10:30pm shortly before PRH opened and now only stays open until 8:30pm.

Call for more 100 more Darwin beds

ACEM president Dr John Bonning said the current situation was "unacceptable" and patient safety was under threat.

"Royal Darwin Hospital is overcrowded, and this is well known to increase risk of harm and death for patients," he said.

"The Darwin hospital system is so stretched that the only solution is a significant increase in appropriately staffed in-patient beds."

Royal Darwin Hospital's ED was seeing about 71,000 patients per year before the new Palmerston facility opened. ( Supplied: Jack Bullen )

In a statement, ACEM said the Darwin hospital system needed "at least 100 more beds" as a matter of urgency. It said every day at RDH, patients were being forced to share cubicles and were being put in "inappropriate spaces" due to a lack of inpatient beds.

But as Dr Parker explained, RDH needs both capital funding to open extra beds and ongoing funding to keep extra wards staffed and operating.

"There's the issue of short term where there is a lack of funding," he said.

Dr Charles Pain said PRH hadn't quite realised its potential. ( ABC News: Jano Gibson )

"Then there is long term — where we need to look at the fact that the NT has twice the rate of avoidable hospital admissions as the rest of Australia.

"The solution is to look at the avoidable admissions and how to reduce them."

Dr Pain said Top End Health Service was doing its best to provide integrated services balanced appropriately between preventive, primary, secondary and tertiary services — but it could always benefit from more funding.

A Top End Health Service spokeswoman said in the 2018-19 financial year, the NT Government spent $25 million running PRH "plus commonwealth activity-based funding along with other sources of revenues".

It spent an additional $1.4 million ferrying patients from PRH to RDH, a service contracted to CareFlight's ground transport service.