Long wait times for doctors' appointments are widespread, but the problem is worse in some areas. Photo: SCIENCE PHOTO LIBRARY
The chronic doctor shortage is being felt across the country, but it is those in the regions and rural areas that are feeling the most pain.
In Dargaville, on-site doctors at the local hospital have been replaced by an overnight telehealth service, while doctors in Rotorua have been told they need to cover the Taupō region because of shortages there.
A consulting doctor who works in Whangārei Hospital and did not want to be identified told Checkpoint the replacement of services in Dargaville Hospital with telehealth overnight was a concerning move.
"Hearing about Dargaville closing overnight and then hearing Doctor Reti's response to that was really upsetting, the idea that some things can be managed over the phone or by telehealth is just not realistic," she said.
"Patients come from a long way away to get to those hospitals."
Some of the conditions that people come into hospitals with need to be seen earlier, she said.
"There have been some wonderful management of patients in these centres that have needed to skip right past Whangārei and head on down to Auckland."
If regional hospitals are going to rely on nursing staff alone, even when they are excellent nurses, resilience needs to be bolstered, she said.
"I'm not hearing a plan that includes that, and I'd be worried if we were relying on them solely, she said."
She said she had seen telehealth work well, with someone who was able to examine well at the site and with clear communication.
However, she said hospitals could not rely on it, especially overnight.
"Overnight is when people come to hospital with emergencies - and the kind of emergencies that are not something you can pick up the phone or pick up a video and manage.
"Even sometimes looking at the colour of a patient, it's not perfectly done.
"It is a tool, but we can't be relying on it, and it can't be the considered as a safe backup."
She said getting to a hospital could be challenging for a patient, depending on their resources.
"Do they have a car? Do they have petrol? Do they have a relative or a friend or someone that can drive them, because it's not particularly safe to be driving yourself when you're very sick," she said.
"When people are assessed and found to need to come to another centre, do we have an ambulance? Do we have an ambulance driver?
"We run very close to the edge of things all the time already.
"And some people don't need transfer, but how do you know that unless you assist them first?"
Another doctor, Mary, said the shortage of doctors was acute in the regional hospital where her dad went to receive treatment for cancer.
"We're hearing all the time that there's no freeze, but then we're told actually they're really struggling to have enough appointments for everybody because someone had gone on maternity leave and someone else was on a fixed term contract that wasn't going to be renewed.
"So they were effectively 20 percent down initially, when dad got the diagnosis."
He had received treatment in the private sector first until his insurance money ran out, and then begun to use the public services.
However, after hearing he had to wait six weeks for another appointment, he was currently paying out of his own pocket for private treatment, she said.
"We talked about that. He's got insurance and there was the option of being in private or public and he sort of felt that he'd paid insurance for the time and had been able to afford to do it and that actually it was sort of helping the health system by then being able to use it in private.
"It kind of makes you feel that if he hadn't done that, then that would have been even worse for everyone else."
She said getting a cancer diagnosis was stressful and people want a timely appointment.
"Most people understand the longer that you have it, the worse your outcome is - and so even if that's not necessarily true, then there is this stress that you want to go and see someone quickly and you want to be able to talk to someone."
She was personally having to work as a registrar in one week in seven to cover shortages.
"They're putting all these delays and roadblocks and making it harder and harder to get people in a timely way," she said.
Rachel, who lives in a rural area, just outside of Dargaville, was shocked to hear the news about Dargaville Hospital.
She said the wait time to see her local GP was lengthy and that must have a domino effect to the hospital system.
"I'm just very glad that I'm actually well at the moment, because when I first came to Dargaville 25 years ago, you could ring up and get an appointment that day or the next day. There were lots of GPs."
She said as years had passed it had become harder to book an appointment with her current GP.
"If I want to make an appointment to see her, I've rung a couple of times and they say 'sorry, her book is closed. Can you please ring back at the beginning of next month and then you can maybe see if you can make an appointment with her'," she said.
"That's just me choosing to use my preferred GP, who I have a relationship with, which I think it's quite important from a health point of view -people that understand you and know what's been going on with your life."
Minister of Health Shane Reti said while the situation in Northland was not ideal, there was adequate funding for ten unfilled health positions across the region.
He said Dargaville's hospital remained viable but might have to rely on alternative service mechanisms until doctor positions could be filled.
