GP avoiders must be tackled

Not too many people head down to a hospital’s emergency department with a tra-la-la. They, or the person they’re taking, will likely be in pain, distress and quite often scared.

Scared not only for medical reasons, either. They’ll perhaps have the added concern that they are going into one of the most notoriously stressful environments around, as witnessed by recent stories that department staff now see dealing with violence as part of their job.

So the ED arrivals may well be feeling the need to stand up for themselves or the person they’re with. The reproach voiced by a bleeding Jimmy Mccrillis, that most of those around him at a packed Waita¯ kere Hospital didn’t seem to be seriously hurt at all, is of course a thoroughly untrained perspective and has been widely criticised as such. He was not well positioned to be making diagnoses.

But easy though it is to scold Mccrillis not to try to diagnose others, self-diagnosis isn’t always easy either. So we shouldn’t be too terribly expansive about requiring others to take their less urgent ailments and injuries away from our EDS when they mightn’t be sure how urgent their need is.

For their part, ED personnel attest that some of the huge pressure they’re under comes from people who have shown up rather than attend an afterhours GP service for which they’d typically pay.

We really do need to separate people who are facing an actual medical emergency from those who don’t meet that criteria, but are nevertheless in urgent need of relief, even reassurance.

Waipareira Trust chief executive John Tamihere notes there were signs at Waita¯ kere Hospital pointing out vouchers were available for free treatment at the nearby White Cross medical centre for people who weren’t badly injured. (Normally it’s $107 at the weekend, he says).

That’s a point. But the wider issue is that the public remains acutely sceptical of the view that the after-hours GP service is the place to head in the first instance. And those who report big, scary bills haven’t been hallucinating.

This is a matter that the Government’s recently announced health review needs to look into good and hard. Also this: it’s not just an after-hours problem. The Gp-avoiding show-ups are common enough at EDS during opening hours for surgeries.

The health review will inevitably meet evidence that EDS are hardly humming with sweet efficiency day in and day out. This time last year the College of Emergency Nurses was going crook about politicians purring over the successes of EDS in meeting the six-hour targets for discharge and transfer. The nurses were, in effect, saying we had care rationing and that care standards were being constrained by the artificiality and impracticality of targets they were being pressured to meet in their under-resourced environment. Still an issue.

On top of problems treating people when they show up where we wish they wouldn’t, we have a different issue among people from some ethnicities not presenting themselves for help when they’re living with chronic pain. We need to help them understand that good citizenship entails not only contributing to society where you should, but drawing support from it when it’s needed.

The public remains acutely sceptical of the view that the after-hours GP service is the place to head in the first instance. And those who report big, scary bills haven’t been hallucinating.