By Lee Scanlon of 
Association of Salaried Medical Specialists chief Sarah Dalton says the plan is "going to leave massive gaps" in healthcare provision on the Coast. Photo: LANCE LAWSON PHOTOGRAPHY / Supplied
The Association of Salaried Medical Specialists (ASMS) has doubled down on its opposition to the West Coast's looming health service cuts.
The Coast's weekend urgent GP clinics end this weekend. From 1 October, Ka Ora telehealth service would be providing primary care after hours, at weekends and public holidays.
Patients would need a referral from Ka Ora to see a doctor or nurse in person.
Primary health organisation West Coast Health (WCH) said the GP clinics were unsustainable from a financial and staffing point of view.
ASMS executive director Sarah Dalton said the WCH proposal had been "incredibly rushed" without proper consultation, risk mitigation or management.
"What's being proposed here is going to leave massive gaps," Dalton told The Westport News. "It's going to cause significant risk to people who are unwell."
Sick people were vulnerable, and should not have to rely on phones and/or computers and the internet for health assessments and diagnoses, she said.
Deploying telehealth on such a wide scale to cut costs was "really problematic" and the Coast was an easy target.
WCH had touted telehealth as an option, but Dalton said it had not provided other options apart from patients reporting to hospital emergency departments.
"If GP practices can't provide that level of after-hours care then it falls on Te Whatu Ora to ensure community-based after-hours care - that is an extension of the services they provide, in my view."
A more appropriate response from WCH would be to look at sustainable staffing levels and how to make health professionals feel supported in rural and remote places, Dalton said.
She was also concerned about medico-legal issues around who was responsible if a telehealth doctor provided the wrong diagnosis or advice.
"Should someone make a phone call, talk to a doctor, get some advice - then something terrible happens. [The patient] hasn't been able to get care, they were misdiagnosed or the timeframes people thought would be reasonable following that conversation weren't met. Then what?"
She noted the West Coast lacked paramedic services and Westport had only one ambulance.
"Not a great place to live if anyone in the family has chronic illnesses or is susceptible. Not a great place to live if you're in a high-risk occupation and there are a number of those on the West Coast."
The change means patients can no longer get urgent medicines from weekend GP clinics. WCH says Westland Pharmacy will fill urgent prescriptions late Saturdays and Sunday mornings and a courier will deliver medicines to patients.
Dalton agreed with an unnamed doctor who told the Greymouth Star the new prescription service would be "clinically inappropriate and unethical".
"Absolutely, that's really unsafe," Dalton said. "It's ridiculous. It's just unacceptable."
WCH has said it will cover the costs associated with the prescription/courier service for the first 12 weeks.
"Then what?" Dalton said.
She agreed with concerns doctors and nurses could end up working longer hours on call under the new system.
WCH has said it will provide extra resources to Buller and Greymouth hospitals for the first three months to ensure their acute-emergency departments were not overwhelmed.
"I'd like to know who's funding that, who does that involve, what consultation with staff has there been, what clinical input has there been to this decision making," Dalton said.
"A lot of this decision-making is made by managers who are not clinicians.
"Honestly, the primary determinant to healthcare at the moment is balancing the books and it's really clear there's not enough funding going into health or, if you want to follow the (commissioner) Lester Levy line, the funding that's going in isn't being appropriately deployed."
Dalton said New Zealand governments had routinely underfunded health for years.
"So now it's really starting to bite and, unfortunately, communities like those on the West Coast are very exposed to this level of health failure."
The ASMS only received the WCH staff consultation document because one of its members sent it to the association, she said. WCH had not responded to the ASMS' submission.
Dalton will be in Westport on Saturday, as will New Zealand Nurses Organisation kaiwhakahaere (manager) Kerri Nuku, to address a planned health protest. It gets underway at Victoria Square at midday and marches to the Clocktower Chambers.
