After-hours clinics on verge of collapse

After-hours medical services in some regions are on the verge of collapse, as overworked GPs signal they can no longer provide cover or funding falls short.

Documents obtained under the Official Information Act show in the first eight months of last year, 24 practices and clinics had to reduce hours or close because of critical staff shortages and cost pressures.

In Porirua, health officials are considering replacing the overnight doctor at Kenepuru Community Hospital’s accident and medical centre with a telehealth service.

Ngāti Toa chief executive Helmut Modlik said in Porirua the iwi-run health service Ora Toa and other clinics already covered Thursday nights and the weekends. He was confident they could provide the doctors — if Te Whatu Ora paid them.

The senior doctors union said staff were seeing more than 20 patients a night. Executive director Sarah Dalton said it was a critical service for more than 100,000 people.

“What is a reasonable level of public health provision, given that we know that people don’t always get acutely unwell or deteriorate quickly between the hours of 8am and 5pm?”

In the 13 months to August, urgent care clinics in Auckland were forced to close early nearly 200 times because of staff shortages.

Nationwide there are more than 100 providers of after-hours care, each with a different mix of funding from Te Whatu Ora, primary health organisations, ACC, private providers and patient co-payments.

Te Whatu Ora has boosted annual funding by $17 million to “stabilise” urgent care services.

But GPs say current funding is not enough to cover the day-to-day work, let alone after-hours care.

The only on-call night-time GP service between Whangārei and Auckland’s North Shore closed in March.

General Practice New Zealand chair Porirua GP Bryan Betty said patients ended up paying the price with “late presentations and presentations to emergency departments which puts pressures on already overstretched services”.

Te Whatu Ora said it was planning to look at urgent care as part of its primary care programme.

Meanwhile, telehealth services were available, and patients in need of urgent treatment could visit a hospital emergency department, it said.