Doctors open all hours
Although most of the area’s GPs were supportive when a centralised afterhours medical service covering much of Central Otago was created, some said it would reduce the levels of care. Central Otago reporter Jono Edwards examines how the Central Otago Aft
AN afterhours service covering four practices in Alexandra and three in Cromwell has treated 1700 patients since it was created in November 2015.
While previously practices would individually offer afterhours care, some Ministry of Health funding was diverted to a new service, based at Dunstan Hospital in Clyde.
A rotating roster was created to tackle doctor ‘‘burn out’’ and improve efficiency.
Last year the service surveyed its patients, doctors and contributing practices.
General manager Jenaya Smith said the patients gave ‘‘very positive’’ reviews of the service.
‘‘There were a few tweaks and finetuning. The GPs said improvements were needed on the facilities we have at Dunstan Hospital, but these were mainly layout issues.’’
Waiting times on the triage phone line were also raised. . Overall, the service was constantly being assessed and improved, she said.
‘‘For the most part we should be grateful to the GPs that are on the roster and to make sure there is a service. Because if we weren’t here, what would happen?’’
The service had roughly 10 GPs on its roster and interest from two more, who would start next month.
There were about 25 GPs in the Alexandra and Cromwell areas but this figure was misleading as many worked parttime, she said.
Alexandra GP Mark Smith said there were pros and cons to the system.
‘‘It means there is a larger pool of GPs, and generally if you’ve been working a night shift you don’t have to work the next day like many used to.’’
The negatives were there were no oncall GPs based in Cromwell after hours.
‘‘It is busier now that we cover both Alexandra and Cromwell. I think it gives adequate care to the region and hopefully we’ll be able to keep it going.’’
Central Otago After Hours chairwoman Christine Williamson said overall the service was working well, but there were constant efforts to improve it.
A recent example was its lobbying of the Government, St John and the Southern District Health Board about the need for an improved ambulance service.
Last month the Government announced a $60 million increase for St John, creating 430 additional frontline jobs over the next four years to provide rural areas with the same crewing levels as urban zones.
St John spokeswoman Victoria Hawkins said the Southland/Otago district would get 32 additional staff but it did not yet have information.
The Roxburgh Medical Centre opted not to be involved in the afterhours service because of its distance from Dunstan Hospital.
While the service can help the area if required, it largely relies on a sole GP and nurses who have received an extra level of training through the Prime system.
The Cromwell Medical Centre opted out of the service and was against its formation.
During its creation the centre’s GPs released a joint statement criticising what they saw as a lack of meaningful engagement on the proposal, a lack of detail and a short timeframe for implementation.
While 75% of GPs in the area supported it, the centre issued a petition supported by 1500 Cromwell locals against the idea.
The practice is still covered by the service’s triage system.
Dr Williamson said there was no compulsion for all GPs to join the roster, but contributions from all practices would have meant a wider spread of the afterhours load.
The Cromwell centre declined to comment.
Miss Smith said while some practices were not contributing to the roster, it was fully staffed.
‘‘We welcome any local GP to join and we hope some of them will in the future. But it’s not crucial that every GP is involved.’’
The cost for enrolled patients is $92 between 6pm and 11pm and $172 for 11pm to 8am. Children under 12 are treated for free.
The patients are treated at the afterhours centre at Dunstan Hospital. Callouts cost an extra $45.
‘‘These costs are the same as or less than what the Wellsouth Primary Health Organisation and other similar afterhours services charge,’’ Mrs Smith said.
Dr Williamson said the fee structure barely covered the cost of the service.
Sustainability of the service into the future depended on many factors, she said.
‘‘The willingness of personnel to continue to participate, improvement of funding streams that recognise the unique demands of tourism, keeping pace with the ageing demographics of our population, continued improvement in our allied ambulance services and a vigilant attention to changing needs as our region evolves.’’
The tourism boom was the ‘‘bane’’ of health funding, she said.
‘‘Health funding for emergency services held by the Southern District Health Board, inadequately funded by central Government, does not follow the thousands of New Zealanders who move to Central Otago during the summer period.’’
jono.edwards@odt.co.nz