Ru­ral health cri­sis won’t solve it­self

South Waikato News - - Your Paper, Your Place - DR NIGEL MUR­RAY

been 50 years since the last med­i­cal school was cre­ated in NZ, and this decades­old model of med­i­cal ed­u­ca­tion is now strug­gling to meet the health needs of all New Zealan­ders.

We have a grow­ing healthcare cri­sis in our pro­vin­cial and ru­ral towns, re­vealed by shock­ingly poor health sta­tis­tics and the pre­ventable dis­eases in many of these com­mu­ni­ties.

The lack of in­no­va­tion in med­i­cal ed­u­ca­tion is con­tribut­ing to this prob­lem.

As the chief ex­ec­u­tive of one of the largest and most ru­ral district health boards, it’s my job and my duty to take di­rect ac­tion to ad­dress this prob­lem. Tin­ker­ing on the mar­gins of the sta­tus quo is not good enough. Fun­da­men­tal re­form is needed with a rad­i­cally new ap­proach.

When I first started my train­ing as a doc­tor at Otago Med­i­cal School in 1979, we were en­cour­aged to look up to the hospi­tal-based spe­cial­ist. We were taught and raised in the cul­ture of the hospi­tal and com­mu­ni­ty­based train­ing was lim­ited and certainly not part of the aca­demic cul­ture.

Un­for­tu­nately there has been lit­tle change in the ex­ist­ing two pro­grammes since I be­gan my ca­reer. Al­though a few more com­mu­nity place­ments have been more re­cently in­tro­duced into the cur­ricu­lum, the aca­demic cultures of Otago and Auck­land schools are ef­fec­tively the same hospi­tal-de­pen­dent in­sti­tu­tions.

The ex­ist­ing med­i­cal schools have made huge con­tri­bu­tions to the health of our so­ci­ety, but now this cus­tom and prac­tice of our ex­ist­ing med­i­cal uni­ver­si­ties must em­brace some­thing new and dis­rup­tive. It is time for a rad­i­cal change in who we se­lect for med­i­cal train­ing, how we train them, where we train them, and where they go when they fin­ish train­ing.

That’s what our Waikato med­i­cal school will do.

The tragic tes­ti­mony to this prob­lem is in our emer­gency de­part­ments. Ac­cess to pri­mary health ser­vices is sig­nif­i­cantly lim­ited in our ru­ral areas and peo­ple are dis­pro­por­tion­ately suf­fer­ing from poorer health out­comes. As a doc­tor and district health board CEO, I am deeply trou­bled when pa­tients come to our Emer­gency Depart­ment with later stage symp­toms of can­cer, to be di­ag­nosed for the first time and of­ten too late.

By re­cruit­ing doc­tors from ru­ral and pro­vin­cial com­mu­ni­ties, train­ing them in small hospi­tals and pri­mary care clin­ics across the re­gion and link­ing them to phar­ma­cists, com­mu­nity-based nurses and mid­wives, and other so­cial agen­cies we can breathe new life into these healthcare fa­cil­i­ties.

Not only will it im­prove peo­ple’s health and well­be­ing but it will also strengthen the econ­omy in the re­gion, bring­ing new health pro­fes­sion­als into towns.

Waikato District Health Board CEO Dr Nigel Mur­ray.

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