Lumsden loses downgrade battle
The Lumsden Maternity Centre has lost its battle to avoid being downgraded, but its directors are not going to give up without a fight.
The Southern District Health Board yesterday announced its financial decisions relating to its integrated primary maternity system of care.
It means the Lumsden centre will be downgraded to a maternal and child hub, meaning it will no longer be a birthing unit.
The centre is run by the Northern Southland Health Company and receives $370,000 funding a year from the DHB.
NSHC director Carrie Adams said yesterday, staff were disappointed and concerned at the decision and they were seeking legal advice.
The closure will affect one practice manager, nine nurses, three cleaners and 10 contracted midwives.
‘‘How many roadside deaths do we need to have before the concerns of this community are taken seriously?’’ Adams asked.
‘‘We don’t know what a hub looks like and as yet we have no idea what effect that will have on our staff, but we are keen to keep dialogue open with the DHB regarding that.
‘‘We need to take time to review the decision and the information we received last night’’
Adams said the ‘‘overwhelming message’’ from the DHB was that Wanaka had a growing population and birthing services were required there.
‘‘It is draconian to say that Lumsden has to go without so that another community benefits. All communities should be treated the same.
In a statement, the DHB says its new plan has a strong emphasis on greater sustainability of the lead maternity care midwifery workforce as it seeks to provide greater support for women and their families across the district.
Maternal and child hubs will be developed in Wanaka, Te Anau, Lumsden, Tuatapere and Ranfurly. They are non-birthing units (except in urgent situations) that bring together resources to better support antenatal and postnatal care.
Primary birthing units are maintained at Lakes District Hospital in Queenstown, Gore Health, Oamaru Hospital and Clutha Health First in Balclutha, Winton Maternity Centre; and will continue at Charlotte Jean Maternity Hospital in Alexandra while the best long-term location of a primary birthing unit in Central Otago is explored.
Southern DHB executive director strategy, primary and community Lisa Gestro said the Southern DHB covered the largest geographic area of any DHB and the climate and geography add further challenges.
‘‘So, we have needed to think differently about how to expand the reach of the care we provide. Developing a new layer of support to LMCs and women through the maternal and child hubs, investing in technology and above all taking steps to support our remote LMC midwives to have their work better renumerated as they carry out their all-important role has been fundamental to this.’’
Clutha-Southland MP Hamish Walker said the DHB’s decision was disappointing and a kick in the guts to Southland and rural New Zealand.
The centre, in northern Southland, provides inpatient and postnatal care for about 100 women a year, who travel from as far away as Queenstown or Te Anau to give birth.
The downgrade comes after five months of consultation, protest marches and petitions.
Walker said he would be meeting directors and National Party spokesperson, Michael Woodhouse on Monday to ‘‘figure out the best way forward.’’
‘‘Just because this decision has been made does not mean our community will lie down and take it.
‘‘What we know is that delays in getting to community care compromises outcomes and could put babies and mothers at greater risk. This is a risk that the Government is forcing on Clutha-Southland mothers by cutting services at Lumsden.
‘‘When this centre closes, mothers may have to travel 130km to give birth because this Government will not listen to the serious concerns raised by the community. this is just wrong.
‘‘Let’s be clear, I will not give up and will discuss options with the directors and community, I sincerely care about our community’’.
Labour list MP Dr Liz Craig, of Invercargill, said she was disappointed to hear the Southern DHB had decided to transition Lumsden from a primary birthing unit to a maternal and child hub.
‘‘In the lead up to this decision, both [NZ First list MP] Mark Patterson and I had met with [Chris Fleming and Lisa Gestro] to raise the community’s concerns with them.
‘‘However, the maternal and child hubs proposed for Te Anau, Wanaka, Tuatapere and Ranfurly are a positive development.
‘‘While their focus will primarily be on providing quality community based antenatal and postnatal care, they will also be fully equipped for urgent births, should the need arise,’’ Craig said.
‘‘The DHB have also signalled the potential exists for these units to be up-scaled to primary birthing units in future, should demand increase.’’
‘‘How many roadside deaths do we need to have before the concerns of this community are taken seriously?’’ NSHC director Carrie Adams
So push has come to shove for the Lumsden Maternity Centre. As things stand, the Southland District Health Board has announced the centre will lose its birthing unit. A move ardently opposed by the people of the area. A disconcertingly large area, when you see it in terms of the new potential travelling distances for those who would now be expected to have their babies delivered elsewhere.
What, then, should we make of the reassurance that even though the centre’s new status would be providing support before and after the event, rather than during it, the centre will nevertheless still be fully equipped for urgent births, should the need arise?
Should it live up to that pledge that would be something. It wouldn’t assuage all concerns, by any means, because in the normal course of things the travelling distances to the farther-flung designated delivery units will be longer and the potential for those roadside deliveries, with their considerably greater risk of bad outcomes, remains greater.
The health board depicts the change as part of a new, improved distribution of resources throughout the region and that Lumsden will be joining a network of maternal and child hubs resourced to provide better antenatal and postnatal care, at the same time establishing a network that better enables the sustainability of a hard-pressed midwifery workforce.
The problem with the existing system, says board chief executive Chris Fleming, is that it evolved through a range of circumstances and historical situations and over time some ‘‘gaps and inequities’’ had developed through the uneven distribution of resources.
One practical upshot of which – at least this is how the Northern Southland Health Company, which runs the Lumsden centre, sees it – is that birthing services disappear from Lumsden and resurface in Wanaka, with its growing population.
Stand far enough back and perhaps the case can be put that resources go where the need is greatest. Stand on a wintry Northern Southland roadside and the perspective shifts somewhat.
It’s highly contestable whether, amid this more exquisitely balanced new system, the whacka-mole dynamic was really necessary
And it may well be contested because the Lumsden centre’s directors and Clutha-Southland MP Hamish Walker are talking about reassessing resistance options even at this stage.
Walker, for one thing, queries whether population growth relevant to Lumsden, notably a 1000-odd housing development planned for Kingston, has itself been given due weight.
What’s more, surely even if Wanaka can claim greater population growth, the need for increasing numbers in the Lumsden catchment isn’t materially lessened as a result.
The board has indicated that there’s always the potential to return Lumsden to the status of a primary birthing unit in future, if demand increases.
Yes, well. Increased demand can present itself through a series of gradual and undramatic statistical developments.
Or it can present itself by way of a torch-carrying mob reacting to exactly the sort of roadside nightmares that the good people of Northern Southland have been warning about.