Health Action Wānaka steering committee (from left): Lucy Middendorf, Monique Mayze, Trish Fraser, Nicky McCarthy, Brigid Loughnan. The group has published a new report showing significant service shortfalls, inequity in accessing care and systemic barriers to health. Photo: Supplied
- One of the country's fastest-growing communities is struggling to access healthcare with a new report showing significant service shortfalls, inequity in accessing care and systemic barriers.
- The Health Action Wānaka-led report found some people were prepared to lose their eyesight because it was too difficult to travel to Dunedin and they couldn't afford private care.
- The group is calling on the Health Minister to commit to three 'quick wins' to help alleviate the community, including telehealth psychiatric consults.
Some Queenstown Lakes communities have to travel seven hours for medical appointments and pay for healthcare that's free in other parts of the district, a new report has found.
The Health Action Wānaka report revealed some people in the Upper Clutha were forced to leave or choose not to access healthcare due to the costs and travel needed.
But without investment, advocates said it would only get worse with Wanaka's population projected to grow at a rate of 144 percent by 2053.
When Wānaka local and Queenstown Lakes Deputy Mayor Quentin Smith injured his spinal cord in 2008, he needed to travel to Christchurch regularly for specialist appointments.
"That's an 11 hour round trip of driving at least, 11 or 12 hour round trip for a 10 minute appointment and that's very hard to do in one day. It could require a flight or two flights and an overnight stay and that stuff isn't covered by the public services either," Smith said.
The population has roughly tripled since he moved to the area more than 20 years ago, but Quentin Smith said the health services hadn't kept up with demand.
"Families are forced to either split their family ... or move away in order to access services for a period of time, and I've seen that first-hand," he said.
The new report from community-led advocacy group, Health Action Wānaka, painted a grim picture of unmet needs, people paying for services that were free in other communities, insufficient funding to meet demand and a lack of planning.
More than 300 community members as well as a wide range of local health professionals were consulted for the research.
Group spokesperson Monique Mayze said infrastructure and services were struggling to keep up with the current demand, let alone the projected growth.
The closest emergency department is at least an hour away in Queenstown.
Health Action Wānaka steering committee chair Monique Mayze. Photo: Supplied
"Just imagine a winter's night, it's very cold, it's very dark. There are a lot of issues on the roads and people being forced to travel over the Crown Range - the highest main road in the country - to get to an emergency department so they can get access to publicly funded healthcare," she said.
"We shouldn't be in that situation, we should be able to get that here in our town."
The report found people were paying for after-hours acute care, x-rays and blood collection, despite these being free for other parts of the country.
Their rural practitioners had the skills to do more publicly-funded procedures, but Mayze said the funding they received wasn't meeting demand and they would run out of it early.
She described the focus groups about mental health as "distressing to hear", with parents describing the struggle to access support for their children.
Residents travelling more than 2000 kilometres for Dunedin Hospital visits over six months were not eligible for reimbursement from the National Travel Assistance scheme, the report said.
The cost and travel times were forcing people to think twice about accessing healthcare, Mayze said.
"Our concern is the people you don't hear about, the people who in the middle of the night need help and find out how much it will cost, and because it is too expensive choose not to access the service and wait until the morning."
The inequity was indefensible and rural taxpayers shouldn't face so many hurdles to access healthcare, she said.
"We'd just like to shift the perception that this is an affluent community that can pay for its private healthcare. We actually have every right to have access to publicly funded services here in the Upper Clutha," she said.
Health Action Wānaka has asked the Health Minister to commit to introducing telehealth psychiatric consults, a publicly funded blood collection service and more access to the publicly funded radiology services announced last June.
Bernard Fouke moved to Wānaka with his wife Susan Ronn in late 2017 just as her health started to rapidly go downhill with a neurodegenerative disease.
They needed to go to Dunedin every three to four months for specialist appointments.
Wānaka resident Bernard Fouke says without private health insurance and their own money, he and his wife would not have been able to live there after her health rapidly went downhill. Photo: Supplied
It was a difficult trip for his wife who uses a wheelchair, taking four to five hours for him to drive them, and requiring an overnight stay and a lot of organisation, he said.
Fouke, a former medical professional, acknowledged they were better off than most because they have private health insurance.
"I can't even imagine being able to do all of this using only the public sector. I don't know how people do it," he said.
"I suspect a lot of people just don't bother with following up on problems because of how arduous it is to go over to Dunedin."
He paid about $850 every two weeks for private health insurance.
Without it and their own money, he said they would not have been able to stay in Wānaka.
"I think they need to go in with eyes wide open, realising that if they're going to depend on public healthcare," he said.
"I don't see how people live here without having access to private care and of course, GP practice is quite expensive too."
He called the new report grim but thorough, and said similar work should be done across the motu to create comprehensive plans for different communities.
Quentin Smith welcomed the report, saying it reinforced what they had known anecdotally for years.
The community was continuing to grow so there needed to be a strategic approach to health services in the area and more investment, he said.
The report found a lack of affordable housing and the cost of living was also putting pressure on the local health workforce.
In the report, Glaucoma Endorsed Therapeutic Optometrist Tui Homer said some patients couldn't afford to keep going to Dunedin for injections for macular degeneration and couldn't afford to pay privately.
"This almost guarantees they will go blind or lose significant vision from the disease. This has a snowball effect on healthcare (increased falls/burns etc) as well as the devastation to the patient," Homer said.
Cardrona Doctors GP Dr Jim Reid said he was completely unprepared for the discrepancies in the resources in the area.
"Blood specimens had to be drawn on site, x-rays and ultrasounds are readily available in the private sector, but had to be paid for and thus were beyond the reach of some patients," Reid said.
Patients would either need ACC or to travel to Queenstown or Dunstan Hospital to get them for free, he said.
Health Action Wānaka has invited the Health Minister to meet with it to discuss possible solutions.
The group wanted to collaborate with local organisations and providers to raise funds for projects, including being able to deliver select specialist services locally - like injections for eye disease, helping patients with complex needs to navigate the health system, and offering respite.
Health Minister Simeon Brown welcomed the report, saying he hoped to meet with Health Action Wānaka soon.
He said his priority was to ensure all New Zealanders received timely, quality healthcare.
"That means delivering health services closer to where Kiwis live and making use of digital consultations particularly for remote communities."
He confirmed he has asked officials for their advice and recommendations on the report.
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