Nurses pan ‘risky’ shake-up

Sweeping changes to the way mental health patients are treated have been labelled ‘‘risky’’ by the union that represents registered nurses who could lose their jobs in the process.

The Midcentral District Health Board is pressing ahead with consultation on a proposal to shake up out-patient adult mental health services designed to make them more responsive to people’s needs.

It is the board’s response to the national inquiry into mental health and addiction services that identified that ‘‘the status quo was no longer an option’’.

The proposal includes earlier community-based support for people in mental distress, improving equity for Maori through kaupapa services, changes to the way crisis intervention teams work, and moving more ongoing outpatient care away from Palmerston North Hospital and into community settings.

But the NZ Nurses Organisation said the proposed changes were risky, badly-timed, and would depend too much on an unregulated, community-based workforce.

Manawatu¯-based union organiser Donna Ryan and professional nurse adviser Wendy Blair said they were concerned about the quality and continuity of care for some 600 clients already in the service.

‘‘And the timing is really poor,’’ said Ryan.

The switch to a more community-based service would be phased in over four years, but recently- announced health reforms indicate the district health boards will themselves be gone next year.

Ryan said it would seem unwise to persevere with the overhaul in one district in light of the health reforms’ purpose to see health services that were equitable across the regions.

She said members were not

against change, but could not understand the detail of how the proposal would be implemented.

One aspect of the proposals was to base the acute care team, the staff responding to mental crises in the community, emergency department and police station, in the mental health ward.

‘‘We have done that before, and it did not work,’’ said Ryan.

Ward 21 has been condemned in several reports as not fit-forpurpose, and planning is under way for a new $30 million ward to be built on the Palmerston North Hospital grounds. ‘‘To think of change without suitable facilities first is incredible,’’ Ryan said.

The proposal does not directly affect in-patient services, but sets up Fact (flexible assertive community treatment services) that would provide long-term support outside the ward for people with severe mental illness.

More out-patient care would be provided in the community, at bases in Tararua, Horowhenua, and Palmerston North.

The clinics currently provided at the Ruahine building, the old nurses’ home at Palmerston North Hospital, would move to another community base at a location yet to be decided.

The out-dated building was targeted for demolition to make way for a new acute services redevelopment at the hospital.

The creation of the Manawatu¯ Integrated Service suggests the loss of 17 current registered nurse positions.

Another arm of the changes would be creation of 10 extra peer support worker roles based in non-governmental organisations in the community. The union questioned how the board could insist other providers employ people in those positions.

District health board acting chief executive Jeff Brown said it would be inappropriate to speculate on potential outcomes while the proposal was out for consultation.

‘‘However, we have been working with our staff and union partners to ensure this process is handled in a professional, respectful and compassionate manner.’’ Consultation closes on May 14.

‘‘To think of change without suitable facilities first is incredible.’’

Donna Ryan

Manawatu¯-based union organiser