’They never see the same doctor twice’
The West Coast District Health Board covers the largest geographical area of all DHBs in New Zealand, yet it serves the smallest population. Under the latest health reform proposals put before the Government, it faces likely amalgamation with its bigger neighbour in Canterbury.
A regular criticism of health services in the area is that it has little continuity of care for patients, because of its heavy reliance on locums.
Westport GP Martin Smith worked at a West Coast DHB general practice for seven years before opening his own private practice in the town six years ago.
He said he would welcome any change to the DHB structure with a ‘‘sigh of relief’’.
He said the DHB could not retain staff because of a bullying culture, where staff were demoralised, unsupported and afraid to speak up.
‘‘There is no continuity of care on the West Coast. People die waiting for diagnoses because they don’t see the same doctor twice.
‘‘We have been on a locum merry-goround for the last 20 years. The DHB says it is because of a nationwide doctor shortage – it’s not.
‘‘They had full-time permanent GPs and they all left, including myself, because they had issues with management they couldn’t resolve.’’
The elected board members have limited powers and cannot effect change, he says. He previously spoke out about some of the region’s patients needlessly suffering while waiting years for orthopaedic surgery.
Karamea man Kent Vickerman fought for care for his wife Nijole for 10 months before she was given a terminal lung cancer diagnosis.
He says she had 25 medical appointments on the West Coast, and various medications for reflux, hay fever and infection, before she was given a chest X-ray on his insistence. He says not having a consistent doctor, instead seeing several locums, exacerbated the situation.
Nijole is now in palliative care as the cancer has spread into her lymph nodes and spine. The couple have been told that, if the cancer had been caught early, she could have made a full recovery. Vickerman has lodged a complaint with the Health and Disability Commissioner.
‘‘I just want accountability. Somebody stuffed this up. I want them to put their hand up and tell me why they still have a job,’’ he says.
Since 2010, the tiny West Coast DHB has shared chief executives and clinical directors with the Canterbury DHB, as well as shared public health and corporate service teams.
Board member Nigel Ogilvie, a nurse and manager of Westland Medical Centre, says he believes there is a high chance the DHB will disappear in the latest overhaul.
However, he does not agree that the shakeup will reduce services on the coast. ‘‘People’s fear that services could diminish is probably unfounded. It could increase services because hospitals would be working more in collaboration and partnership.
‘‘There’s always going to be problems in small rural towns. We are really lucky to have services provided by Canterbury.
‘‘It’s not perfect. I’m not saying that every person I wish to be seen gets seen, but we are lucky with where we are at.
‘‘I believe not having elected members would be a large mistake. People that are elected by the community do their level best we can for the community, as well as the best we can for the DHB.
‘‘If we lose elected members we will see a reduction in the ability to fight for the community.’’
Consumer adviser for the DHB Joe Hall says that, when she was a patient two years ago, she could not fault the care she received.
‘‘We are pretty well taken care of. I have all the confidence in the world. I had my aorta split open and nearly died and within 20 minutes they had me on a plane to Wellington for a 12-hour operation that saved my life.’’
Given its geographical size, covering a distance as great as that between Auckland and Wellington, the West Coast needs more people on the ground working with the community, particularly in rural and isolated communities, she says.
‘‘We need the board. West Coast services would diminish hugely [without local representation] and it would cost jobs. We are not asking for miracles, but just what’s reasonable.’’
Rick Barker, chairman of West Coast DHB, says any decisions about the future of the board are for the Government to make.
‘‘The interests of those needing healthcare must be placed ahead of the interests of boards – people have to be the priority.
‘‘The board will meet later in the month and may decide to express a view or to leave that to individual board members.’’
In response to Smith’s claims, he says: ‘‘As a DHB we do not accept any form of bullying in the workplace and refute the accusation that there is a bullying culture throughout the organisation.’’
He adds: ‘‘The use of locums does not limit continuity of care, but ensures that we are well placed to provide ongoing appropriate care to our patients.’’