Doctors Art Nahill, left, and Glenn Colquhoun in Kerikeri on the second stop of their 'Hīkoi for Health'. Photo: RNZ/Peter de Graaf
Creeping privatisation and decades of neglect by successive governments are among the top concerns uncovered by doctors travelling the length of the North Island to hear people's views about the health system.
Auckland hospital doctor Art Nahill and Horowhenua adolescent general practitioner Glenn Colquhoun spent two weeks on a 'Hīkoi for Health' from Kaitāia to Wellington, arriving in the capital on 8 May.
Along the way, they tried to speak to as many people as possible about their healthcare experiences and their ideas about how the country's creaking health system could be fixed.
Nahill said they were still working through the submissions and interviews they collected, but anger and frustration were common themes.
"I know a hīkoi like this will self-select people who have had bad experiences, but we had a number of people who had very good healthcare experiences, but who are still angry and frustrated at the conditions under which healthcare workers are being asked to perform their roles," Nahill said.
Another key theme to emerge was the need for a more robust public health system, focussed on keeping people healthy in the first place by ensuring access to good food, water and housing.
"I think a lot of people realise that we have to turn off the tap of very unwell patients turning up to emergency rooms and other urgent care facilities," he said.
Another common thread was the need for better access to health care providers.
"There are people who have been waiting years to try to register with a GP, but all the books in the practices in that locale are all closed. There are lots and lots of people who are debilitated by things like arthritis in their hips or knees, who are waiting years to even be put on waiting lists, so people are getting very fed up with waiting."
Nahill said many people wanted more funding for the healthcare system, although in his view, more investment on its own would not fix the problems.
Simply training more doctors and nurses, for example, would not necessarily help, because there was nothing to keep them in a "broken healthcare system", when they could easily find work overseas.
The Hīkoi for Health 'vanbulance' was transformed into a mobile work of art by painter Nigel Brown. Photo: RNZ/Peter de Graaf
Many people they spoke to were angry about what they described as decades-long neglect of the health system and fearful of the way privatisation seemed to be occurring without public discussion.
Nahill said he shared some of those concerns about privatisation, highlighted by a recent decision by Health New Zealand to outsource thousands of operations to private hospitals.
"We only have a certain number of doctors in New Zealand, and if they work more and more in private, that means there are fewer and fewer of them available to do the same procedures in public, which means the waiting lists grow. We then have to outsource again to the private system, so it seems to me to be a silly way to deal with waiting lists."
One of the stories that stood out for him from the two-week journey was from the father of a young girl who died in hospital, possibly due to a medical error, though that was unclear.
"His only contact with the hospital after his daughter's death was a text several months later, offering him a few sessions of counselling to deal with his grief. He was incredibly angry and didn't know where to go."
Another story was from a Kaitāia couple, who had tried to register with a GP for three years, but all practices in the town had closed their books.
If they needed to see a doctor, they had to go to the emergency department or after-hours clinic at Kaitāia Hospital, or travel to Tauranga - an eight-hour drive each way - where their previous GP was based.
However, Nahill said they also heard many positive stories about community organisations, iwi health providers especially, working creatively and cobbling together funding from various sources "to fill in the gaps that the broken healthcare system has left".
"It struck us that, if we could scale up some of those small community services or find a way to allow more communities to manage their own healthcare, that might be the best healthcare system we could devise," he said.
The next step in the project would be to assemble an expert thinktank to come up with a plan for a new kind of health system that addressed as many of the concerns raised during the hīkoi as possible.
Nahill expected that would be completed in 8-12 months.
Outside their day jobs in medicine, both Nahill and Colquhoun are known for their poetry.
Nahill was not yet sure if the hīkoi would inspire any fresh writing, because he never intentionally set out to write poems.
"Once an idea or an image marinates in my brain for long enough, poetry begins to form itself," he said. "I'm sure, at some point in time, some creative writing will come out of this hīkoi, it just needs a much longer period of time to marinate."
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