Central Otago Mirror - - WANAKA NEWS - Wanaka doc­tors Dunedin to face facts urge

Feeney’s hope many more will make a sim­i­lar ca­reer choice.

Dun­stan em­braced the ‘‘ru­ral gen­er­al­ist’’ way of think­ing many years ago and was now re­garded as a cen­tre of train­ing ex­cel­lence, with a wait­ing list of doc­tors want­ing to work there, while other hos­pi­tals were keen to repli­cate Dun­stan’s model, Feeney said.

A ‘‘whole per­son ap­proach’’ to pa­tient care was shared by nurses and al­lied ther­a­pists to get pa­tients back home.

Now that Dun­stan’s bed num­bers and high de­pen­dency unit were threat­ened by fund­ing cuts, Dun­stan could lose its role as a ‘‘half­way’’ post be­tween home and Dunedin Hos­pi­tal, putting more pres­sure on fam­i­lies and the St John Am­bu­lance char­ity, Feeney said.

‘‘They have a pro­fes­sional am­bu­lance crew and a very large num­ber of vol­un­teers. But they are be­ing stretched and we are al­ready see­ing de­lays in get­ting pa­tients to Dun­stan . . . And there’s a good chance we won’t be trans­port­ing them to Dun­stan any­more. We will be send­ing them straight to Dunedin,’’ Feeney said.

Wanaka’s mes­sage to the South­ern Dis­trict Health Board last week was clear: sort out ex­pen­sive, in­fre­quently-re­quired spe­cial­ist ser­vices and cull un­nec­es­sary pa­tients from Dunedin’s emer­gency depart­ment rather than attack an ef­fi­ciently run, ru­ral hos­pi­tal with char­i­ta­ble sta­tus, where the lo­cal di­rec­tors are per­son­ally li­able if the out­fit fails.

Wanaka Med­i­cal Cen­tre GP An­drew McLeod says this means the hos­pi­tal and the public must make some tough ad­just­ments.

On the hos­pi­tal’s part, this could mean re­vers­ing a de­ci­sion to keep neu­ro­surgery in Dunedin.

Mean­while, the en­tire 300,000-strong south­ern public, not just ru­ral pa­tients, may have to ac­cept trav­el­ling to spe­cial­ist hubs in other cen­tres.

In 2010, this news or­gan­i­sa­tion went to the streets with a public cam­paign to keep neu­ro­surgery spe­cial­ists in Dunedin. But McLeod says the ‘‘ harsh re­al­ity is that it should have been sent to Christchurch’’.

As­pir­ing Med­i­cal Cen­tre GP Fiona MacLean agrees. ‘‘I think most would pre­fer neu­ro­surgery in a big cen­tre that does lots of it.’’

Other ex­am­ples of the spe­cial­ist hub model al­ready ex­ist, for ex­am­ple,at Bur­wood Hos­pi­tal (spinal in­jury) and Auck­land’s Star­ship Hos­pi­tal (spe­cial­ist ser­vices for sick chil­dren).

MacLean said the pres­sure on St John Am­bu­lance to do more trans­fers to Dunedin Hos­pi­tal was ‘‘the ele­phant in the room’’.

St John Am­bu­lance is funded by the Min­istry of Health, ACC and dona­tions and re­lies heav­ily on vol­un­teer sup­port.

McLeod agreed. ‘‘We have got to have re­li­able easy trans­port sys­tems and we are re­ly­ing on a char­ity. That is noth­ing against St John, but they are not in­cluded in the health sys­tem,’’ he said.

Wanaka has two med­i­cal cen­tres serv­ing a pop­u­la­tion of about 9036 lo­cals (cen­sus 2013), as well many South West­land res­i­dents who travel over the Haast Pass.

Sev­eral years ago, the prac­tices com­bined with other al­lied health ser­vices to form Wanaka Lakes Health Cen­tre. While they re­main sep­a­rate busi­nesses, they work col­lab­o­ra­tively and share af­ter-hours du­ties. Nei­ther the health cen­tre nor Dun­stan Hos­pi­tal pro­vide emer­gency ser­vices care.

The re­sult of the health board’s fund­ing ne­go­ti­a­tions with Cen­tral Otago Health Ser­vices Ltd are not yet known.

The board meets in In­ver­cargill on Thurs­day, June 4, and COHSL meets next Tues­day, June 9.

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