‘Patients could die’
EXCLUSIVE: HEALTH CHIEFS WARN GOVT
Anew regime for treating addicts is so underfunded it risks unethical “revolving door” treatment that could lead to chronic homelessness, seizures and death, health boards have warned the Government.
In an extraordinary letter to Health Minister David Clark, Auckland’s district health boards slammed a lack of funding for a law change to give compulsory treatment to the worst drug and alcohol addicts, which will create more work and responsibility for DHBs.
Dr Lester Levy, then chair of Auckland, Counties Manukau and Waitemata, wrote of big gaps in alcohol and drug treatment, including respite services — and said the support that is already in place is overburdened.
Clark declined to comment on the letter yesterday, saying the matter was subject to a Budget process.
Levy wrote to Clark in January this year, shortly before the Substance Addiction (Compulsory Assessment and Treatment) Act 2017 came into effect on February 21.
“Without additional resource those discharged from the legislation are likely to be lost to follow-up, return to homelessness, relapse to chronic substance misuse, become critically unwell or injured, re-present at emergency departments and be readmitted to medical wards or medical detox facilities,” Levy wrote.
Cycles of detox and relapse would worsen symptoms of withdrawal, and could have serious medical consequences including convulsions, seizures, hallucinations, extreme anxiety and death.
“To summarise, we believe it would be potentially unethical to place people experiencing a chronic relapsing condition and impaired cognitive functioning and/or brain injury under compulsory treatment legislation in the absence of appropriate funded detoxification
treatment and aftercare services.”
The new substance addiction law allows a third party such as a family member to apply for a person to get compulsory treatment, if a specialist signs it off.
It passed under the previous National-led Government and replaced a 1966 law, setting a higher threshold for care and adding greater protections for patients’ rights.
Levy told Clark concerns were raised with the previous Government at every opportunity.
The claims will add to the debate over health spending. Prime Minister Jacinda Ardern this week responded to mould and asbestos issues at Middlemore Hospital by saying health underspending “is worse than we thought”.
National says the Labour Government doesn’t have the funds to invest in health infrastructure, after big campaign pledges like free tertiary study.
In his letter Levy said there was a lack of funded specialist roles needed under the new regime. Before addicts could be sent to the Nova Star national service in Christchurch a comprehensive detoxification in their home DHB was needed.
That process would put more strain on near-full facilities, he said, and significant delays in getting treatment at Nova Star were likely. Avail- ability of treatment services for voluntary patients could also reduce.
Levy — whose resignation as chair of the DHBs took effect in January — told Clark DHBs faced an “impossible task”, leaving them and the Government in “the unenviable position of substantial clinical, organisational and reputational risks”.
“It is important to note that this is all in the context of an already overburdened and in our view, chronically under-funded alcohol and drugs sector.”
The DHBs called for an immediate funding of specialist roles, and for consideration for “flexibility” to be given around the requirements of the law change in the first 12 months.
Levy suggested a potential solution was to partner with the Auckland City Mission to co-locate detox facilities in its new multi-million dollar redevelopment of its CBD premises.
Clark told the Herald he had assured New Zealanders that the Government will “fund health better than the previous Government” but he could not comment because “this is subject to a Budget process”.
A planned mental health inquiry will cover addiction services.
National’s voice on health, Michael Woodhouse, said, “If Dr Clark agrees with Dr Levy he has it in his power to fix with some of the $8 billion he intends to invest into health.”