West Coasters won't be consulted on health cuts

By Lee Scanlon of The Westport News

West Coasters will not be consulted before their weekend GP clinics are replaced with telehealth from 1 October.

The proposal was revealed in a staff consultation document leaked to the media last month.

At the time, West Coast Health chief executive Caro Findlay told The Westport News the community would be consulted as soon as staff feedback was in. She had expected community consultation to begin last week.

However, Findlay confirmed on Tuesday there would be no community consultation. She said every West Coast home would receive a flyer from next Monday, telling them about the service change.

Delaying the change had been considered, but GP clinics had staffing issues, she said.

"If people come back to us and give us feedback about how we can improve it, that's fantastic. But I wouldn't say it's consultation in the sense of 'let's get together and work out how this system is going to work'.

"This is about, 'We're losing services from the first of October. let's put a solution in place and then what we can do once we've got a baseline in place, we can look for improvements then.'"

Findlay was unable to provide details of the new service. She said primary health organisation West Coast Health first needed to respond to the New Zealand Nurses Organisation's concerns.

"Their concerns are telehealth is not as good as a face-to-face consultation, and we agree with them… [but] most, or the vast majority of issues, can be resolved via telehealth."

Other West Coast health staff were worried emergency departments (EDs) would be overloaded when weekend GP clinics stopped, she said.

However, there would always be a doctor or nurse available for people who needed an in-person consultation, Findlay said.

"If we could have our way we would have 24/7 medical care, but we just can't. This is about ensuring, with the staffing and the money we've got, we could help those people."

Findlay said if the change didn't happen, West Coast weekend clinics would still close because they had too few staff and were running at a loss.

"We wouldn't have all the systems we've set up to support the changeover."

People would end up overwhelming emergency departments and hospitals, she said.

Staff had suggested other options, but they would take too much time to implement.

More government funding was the only answer, Findlay said.

The current primary health funding formula was based on patient numbers, ages and genders, regardless of where people lived.

The West Coast was funded for 31,500 people, who were geographically spread over the large region. Christchurch primary care received the same pro-rata funding but had a much smaller geographical area, a much larger workforce, access to a major tertiary hospital and 24-hour urgent care clinics.

"And we probably have the hardest region in New Zealand, with the lowest population to be able to manage that successfully."

The pamphlets going out next week had been delayed by waiting for Health NZ West Coast to confirm how it would provide urgent medicines at weekends, Findlay said.

The previous proposal was for one pharmacy to open coastwide at weekends and medicines to be couriered to people who needed them.

Westport pharmacist Julie Knudsen said last month that would never work because couriers weren't available until the following Monday. Knudsen said urgent medicines which were currently available at weekend GP clinics should be provided at local hospitals.

Findlay said that was now being proposed.

Findlay said claims by the Buller Hospital Action Group, that telehealth service Ka Ora would charge Coasters aged 14-64 up to $79 for a clinician's consultation, and up to $99 after 10pm, were incorrect.

West Coast Health had negotiated a $50 adult rate with Ka Ora from 1 October. However, she acknowledged patients could also face a St John bill - which the action group said could be $200, Findlay said.