Photo: Paul Walmsley
Rural medical practices are eagerly awaiting a rule change that will allow them to send paramedics to emergencies and accidents.
Under the current rules, GPs or nurses from health clinics are generally the ones that have to attend.
Hammer Springs Health Centre practise manager Paul Walmsley told Nine to Noon it's "bureaucracy gone mad".
"Legislation that just doesn't seem to have worked for many many years and we've really not thought outside of the box."
Their practice covered a huge geographical area and was 135km away from the nearest hospital.
When ambulances would take some time to turn up to a scene, the were called as a Primary Response in Medical Emergencies (PRIME).
PRIME is coordinated by Hato Hone St John and funded by the Ministry of Health and ACC.
"What's been expected in the past, for the last 20 plus years, is our GP's and those practitioners or nurses who work during the day respond to those calls both during the day and out of hours and at weekends," Walmsley explains.
That means cancelling appointments and delaying other people's primary care if an emergency happens during the day, and being available all hours.
"We may be called to a medical cardiac issue, through to being a tourist village, accidents such as people falling off the mountain bike with breakages like fractures."
The change is going to make a "big difference" for their practice, especially as they already have a paramedic on staff.
Being able to use them will increase the weekend workforce by 25 percent, Walmsley says.
"We have a four week roster and immediately on December the 19th, one of my staffing issues and the load on the GP's will reduce.
"The paramedic actually potentially offers just the same skills or if not even more emergency management care for patients."
Walmsley also hopes it will encourage other practices to come back on board with PRIME services, with many having given up because of overwhelming workloads.
PRIME chair Mark Eager says they're the ambulance at the bottom of the cliff, but without an ambulance.
"It is the last line because there is no paramedic available when you ring 111... nothing's going to come unless a PRIME responder comes out. An ambulance will get there eventually, but, essentially, they're the people on on the spot."
PRIME received between 500 and 600 calls a month, but only half are attended due to capacity.
"They are attended eventually, but just not by PRIME.
"So if there's a car accident on the pass somewhere, the local people may get called, they may not be able to respond because there's no one in the town, so then the ambulance will come, that may take an extra 30 or 40 (minutes) or an hour depending how far away you are."
Eager says given the overall problems with rural healthcare and workforce shortages, PRIME responders cover a lot.
"Paramedics that work in PRIME in primary care can respond to medical emergencies, so if you have a chest pain, however if you fall off your mountain bike, you're not allowed to go. So it was bureaucracy gone mad," he agreed.
And while PRIME callouts paid well, "paying people doesn't make them less tired".
Eager was heartened to see rural included as a priority population in recent health legislation.
"I'm very pessimistic with bureaucracy, however, for the first time ever, I think we're going to see some massive changes."
Sign up for Ngā Pitopito Kōrero, a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
