Urgent Primary Care And After Hour Services To Close On The West Coast

A leaked document authored by West Coast Health and marked “Confidential for Te Whatu Ora staff only” proposes that urgent primary care and after hour services will be offered via telehealth rather than by doctors and registered nurses for the entire West Coast from Karamea in the north, to Haast in the south.

West Coast Health, the Primary Health Organisation that services the West Coast, states “High workloads and recruitment issues are impacting on West Coast primary care practices’ ability to staff weekend clinics.” Furthermore, West Coast Health maintains that clinicians can no longer sustain working weekends or after-hours after having worked a full-time shift. West Coast practices are also under considerable financial strain given that the capitation funding formula and the quantum of funding being inadequate.

The proposed telehealth service is to have all West Coast practices enrolled with the Ka Ora Telecare National Rural Telehealth Service. The service can be accessed by phoning 0800 2KA ORA or by visiting kaora.co.nz with patients needing data or a Wi-Fi connection and an active email for an online consultation. If patients aged 15 or over access a GP consultation, they will be charged a fee. If emergency care is required, the patient will be directed to the relevant emergency provider.

The West Coast has the longest boundary of any region that exceeds 600 kilometres and has a population of over 32,000 with a much higher proportion of people aged 65 or older. As of the 2018 Census, the West Coast had the worst rate in New Zealand of households with access to a cell phone and cell phone reception is variable outside of the main population centres. The 2018 Census also revealed that access to the internet on the West Coast is also lower than other regions of the country with Westland just under 80%, Grey at 77%, and Buller at 72%.

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States Chair of Patient Voice Aotearoa, Malcolm Mulholland, “The closing of urgent primary care and after-hours health services on the West Coast will have dire consequences for the people of the West Coast. The isolated region has an older population with higher health needs with less access to cellphone and the internet. It’s a recipe for disaster.

“My first fear is for people who will urgently need emergency services on the West Coast. The Acute Stabilisation Unit (ASU) in Te Rau Kawakawa/Buller Hospital and the Emergency Department at Te Nikau/Greymouth Hospital are under immense pressure with Buller Hospital’s ASU having had to shut its doors for approximately one month since being open in May 2023 due to understaffing. It is understood that Hato Hone/St John only have one ambulance servicing the Buller and the entire region is without an ambulance when transferring patients to Greymouth. For the first year of operation, Te Rau Kawakawa/Buller Hospital transferred over 100 patients to Greymouth Hospital. The second ambulance is staffed by volunteers who are largely unable to assist due to being time poor. PRIME nurses are normally staffing the ASU at Buller Hospital due to understaffing which has resulted in the community being without a PRIME nurse since June.

“My second fear is for those who live in isolated communities who have no or intermittent cellphone and/or internet use. They may struggle greatly to access telehealth services at a time when they need them urgently. Being able to attend the local clinic may be the best option available to them rather than trying to find a location so they can use their cell phone or computer.

“I am not being critical of the stressed health workforce of the West Coast. Clearly, they are overworked and underpaid by a health system that has failed to appreciate the challenges they face. Patients sympathise greatly with healthcare workers and see the anxieties they face daily. More must be done to meet their needs and to alleviate the challenges they encounter.

“Telehealth does have its place in the future of healthcare in New Zealand, especially as the country grapples with a lack of doctors and nurses. However, it is not the silver bullet being promoted by the West Coast Health proposal and is only one tool that can be utilised in certain circumstances. More needs to be done to explore all options. This may include keeping some clinics open after-hours in more isolated communities, having two more emergency care helicopters that can be based in Westport and Fox Glacier to transport patients in need of emergency care, or bonding newly graduated doctors to rural areas in exchange for paying their student loan.

“I urge West Coast Health and West Coast Health New Zealand to pause, consult with the community, and survey all options before making any final decisions about the future of urgent and after-hours healthcare on the West Coast.

To visit the petition to fix the staffing shortages at Buller Hospital, please visit: https://www.change.org/p/fix-the-staffing-shortages-at-buller-hospital

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