Mayor questions viability of Porirua after-hours health
Porirua’s mayor says it may no longer be viable to keep the city’s only after-hours health service open at Kenepuru Community Hospital for “a handful of patients”, given cost pressures.
Each night between seven and 14 “low acuity” patients use the service, health officials say, while expensive temporary doctors keep it going.
“Just to have it overnight for a handful of patients ... it is not needed from that point of view,” mayor Anita Baker said.
“I know they’re spending a lot of money keeping it open and I’m not sure that’s viable. Are we just keeping something open because no-one wants to be the person to shut it?”
The Post revealed in September health officials were considering closing Kenepuru’s Accident and Medical Clinic (KAMC) between 10pm and 7am due to staff shortages, referring the public instead to a telehealth service.
But with Health New Zealand yet to make a call on the service’s future, it has been argued the round-the-clock service is fundamental to the 80,000 residents it serves.
At the time, then-Health Minister Ayesha Verrall said shortages did not justify a closure, while the Association of Salaried Medical Specialists (ASMS) sought an injunction on the closure, arguing Health NZ breached its agreement with them by never consulting with members.
The service has been staffed with locums ever since. Baker understood these temporary doctors were getting about $150 an hour for the 10-hour shift.
“Does that outweigh what they could be doing somewhere else?” Baker said.
The figure Baker referenced was about the mid-point for a locum shift that would be staffed by a resident doctor at between $130 and $180 an hour, according to figures from the NZ Resident Doctors Association (NZRDA) on standard rates.
Dr Deborah Powell, NZRDA national secretary, said staffing a service with temporary doctors could cost more than 50% what it would cost if staff were permanent.
But she stressed a closure at Kenepuru risked overloading nearby services.
“If [those patients] went to Wellington, I just don’t know that they’d cope.”
Powell, who once worked as a doctor at the after hours clinic, said a conversation around sustainable funding at the wider Kenepuru Hospital was desperately needed. “If you can spend that money on locums, for God’s sake, give that money as an operating budget so we can run this place properly.”
The ASMS wants the service to stay “because of the massive equity and access issues that that would uncover and exacerbate at a time when we're coming into winter” and the possibility of a Covid-19 surge.
Health NZ – Te Whatu Ora, Capital, Coast and Hutt Valley declined to comment on the cost of keeping the service open.
But group director for hospital and specialist services Jamie Duncan said the agency was exploring all options on how it could support the community overnight.
That could include “looking at how we allocate our resources differently”, as well as recruiting and exploring whether a workforce nationally and internationally could help. An overnight “virtual service” remained an option, he said.
Health Minister Shane Reti did not answer questions on whether he expected the service to remain open or whether he had requested a cost benefit analysis.
He encouraged Health NZ to explore and investigate all options to ensure the health needs of the community served by the service could be met.
Duncan said once final decisions had been agreed, Health NZ would let the community know in advance.