‘If they can’t do it we will’
Ngāti Toa’s leader says he will not allow health authorities to replace Porirua’s overnight medical service with a telehealth service, saying if Health New Zealand can’t find doctors, his iwi will.
Health New Zealand Te Whatu Ora is yet to make a decision on replacing the 10pm to 8am overnight service at Kenepuru’s Accident and Medical Centre with a virtual health service due to doctor shortages.
Ngāti Toa’s chief executive Helmut Modlik said anything less than an in-person overnight service was unacceptable.
“If they won’t action on their own volition what’s needed, we will,” he said. “Porirua has some of the highest concentration of deprivation and need anywhere. The idea you would unwind in any degree, the availability of care is scarcely credible.”
The overnight service has been staffed by temporary senior doctors, who come at a high cost, since at least September last year.
Despite mounting pressure from community leaders and the senior doctors union, neither the health agency nor the health minister will commit to a timeline for a resolution.
It comes as senior urgent care physician outlines the value of the service.
“If the service is closed overnight I expect patients will chose to wait out time-sensitive conditions at home,” said Dr Tom Sanders, speaking as a member of the Association of Salaried Medical Specialists (ASMS).
He said subtle signs of illness were best assessed in person.
Sanders did overnight shifts at Kenepuru’s Accident and Medical Centre for 15 years, until mid-2022 when it became “too demanding”. “It’s not uncommon now for the overnight doctor to see sort of upwards of 20 patients in one shift.”
Typically, one or two of those patients would be considered “high acuity” – experiencing a severe problem that means they need urgent help, he said.
Then there were patients who might not appear serious, such as the patient who appeared one night with what she thought was a toothache. “Turned out she was having a heart attack,” Sanders said.
Mana MP Barbara Edmonds is ready to picket to save the service, as are hundreds of others she has spoken to in the community.
“It feels like no one is listening ... and no one is talking to us. They’re also saying ‘we’ll make a decision and then we’ll let the community know’. This is the wrong place for that sort of approach ... engage with us, talk through the difficulties and see how we can support you.”
Health NZ’s hospital and specialist services spokesperson for Capital, Coast and Hutt Valley, Jamie Duncan, said the agency had been working with Ngāti Toa and the ASMS on how to the community’s needs “with the resources we have”. That still included a possible virtual service “while we look for a longer term solution”.
Telehealth was still under consideration “both locally and at a national level”, and no decision had been made, Duncan said.
Modlik expected health authorities to engage with Ngāti Toa and its primary health organisation arm, Ora Toa, about a solution that retained round-the-clock in-person health services. “We expect them to cooperate with that, to support that, to fund that. Since they can’t find people, we will.”
While the details would have to be worked through, Modlik said it would likely involve doctors from the iwi’s health organisation arm, Ora Toa, other local doctors and new recruits.
ASMS executive director Sarah Dalton accused Health NZ of refusing to properly invest in Kenepuru’s overnight service, calling it “systemic racism in action”. “It’s treating that whole community as though they are rural and remote.”