Southern District Health Board (SDHB) chief executive Chris Fleming says rural trust hospitals and the SDHB collaborate to provide ‘‘excellent’ healthcare in the southern region, which he reminds us is the largest geographic area in New Zealand, yet with
Q Do you think there is an inequity in Central
Otago from there being no accident and emergency department at
Dunstan Hospital and patients having to pay for their own emergency and after hours medical appointments, unlike in larger centres where free
A and E services are provided?
The SDHB funds an emergency department (ED) at
Dunstan Hospital, although there is no provision for ‘‘walkin’’ patients. Patients arrive at the ED either by ambulance or on referral from a GP, who provides initial treatment. There is no single ‘‘onesizefitsall’’ template for local health services and models of care evolve and change over time across both rural and urban communities to meet the changing demographics and circumstances. There is access to a wide range of services at a local level and, through telemedicine and other initiations, we are improving access to secondary care and specialist services throughout the district.
Q Does the SDHB have any plans to investigate or provide an A and E service at Dunstan Hospital?
There are no plans at present to change the way we fund ED services at Dunstan Hospital.
Q The Central Otago community, through trusts and fundraising, had to pay for the fitout of and equipment in Dunstan Hospital and still pays for all replacement equipment in the hospital. It also paid for the CT scanner and scanner suite there. Why should they have to do this, when city counterparts do not?
We acknowledge the valuable work the Central Otago community does in its volunteer work, in particular services to health and in fundraising for facilities and equipment.
There is a wide network of volunteer and notforprofit organisations across the southern district that contributes resources to assist the health system. All their work helps provide additional services and to stretch the health dollar that little bit further. SDHB provides the ongoing funding that covers the operating costs of the CT [scanner] at Dunstan Hospital.
Q What do you think in general about the funding of rural healthcare, in places such as Central Otago? Does it get enough funding, including for the migration of seasonal visitors there in peak holiday seasons?
In general, there is a fine balance in ensuring the funding available is allocated in such a way that it provides for the right services, at the right time and in the right place. This covers the spectrum of health services from primary care through to tertiary services located in urban areas. We are fortunate in SDHB to have a well-distributed network of health service providers including General Practice and a network of rural hospitals. It is important to note that while SDHB is the major funder of health services, the Ministry of Health and ACC have significant roles to play in funding some services in rural areas.
Q Are there any advantages to the model of healthcare that exists in Central Otago, e.g. from GPs providing initial emergency treatment or from lower wait times for treatment in emergency situations, from GPs and at Dunstan Hospital?
The overall model of care in place for Central Otago generally works well but, of course, there are always areas that can be enhanced and improved. Advantages include a close working relationship between GPs and Dunstan Hospital in ensuring patients are cared for as close to home as possible, including avoiding attending hospital where this is appropriate.