A new needle exchange provider says ideas are being explored to widen access, including mobile services and deliveries (file photo). Photo: RNZ / Rob Dixon
New-look needle exchange services have rolled out across the South Island this week as Te Waipounamu Collective takes the reins from long-time provider DISC Trust.
From this week the service - offering sterile injecting equipment and harm reduction advice - is being overseen by Te Waipounamu Collective's four providers: Ngā Kete Pounamu, He Waka Tapu, Poutini Waiora and Te Piki Oranga.
Clients could expect almost business as usual, said He Waka Tapu interim chief executive Toni Tinirau.
"Our sites have been either kept where they are or we've found a location close to where a former site has been, just to try and make sure the change isn't too big for the consumer group," she said.
"We've also employed, in all of our sites, current peer workforce. So that's been really an incredible opportunity for us as the new provider, to tap into knowledge and experience."
Health NZ's decision to award the contract to a new organisation earlier this year sparked fears among clients and staff that the change could undermine trust.
Uncertainty also loomed over 19 jobs at the needle exchanges, which were largely staffed by people with first-hand experience of drug use.
The total budget for South Island needle exchange services was reduced from $1.4 million to $1 million.
DISC Trust formerly operated needle exchanges in Nelson, Ashburton, Timaru, Dunedin, Invercargill and two locations in Christchurch.
He Waka Tapu had amalgamated the Christchurch sites into one new venue in Pages Road, Wainoni, to allow DISC Trust to continue providing other harm reduction services, but all other venues remained the same, Tinirau said.
Feedback from clients on the opening day had been overwhelmingly positive, she said.
"We were informed that consumers may not access a site for maybe a month or two when the service moves. But we had our first person through first thing on [Tuesday] morning, and we have since had a good stream of consumers coming in and picking up equipment."
Many of the staff who had worked for DISC Trust kept jobs at the needle exchanges, although Tinirau was unable to say exactly how many.
Te Waipounamu Collective had taken expressions of interest from people keen to continue their employment, she said.
"We've probably employed most people that put through an expression. While some wanted longer hours, it meant that we didn't need as many casual people employed at this stage, but that's not to say going forward that we wouldn't be looking for some more."
Earlier, more than 100 clients formed a group called the Peer Injection Collective (PIC) and delivered a four-page open letter to the DISC Trust's board and chairperson, asking for the handover to be slowed down for a "patient and open process of relationship building with the community".
At the time, PIC member Gilbert May told RNZ the group was increasingly apprehensive about the change of providers, and their lack of input into the process, while one Christchurch drug user told RNZ he was worried He Waka Tapu would not have the same level of impartiality because it also offered a range of rehabilitation and treatment plans.
DISC Trust's national harm reduction coordinator Jason George said while the handover to Te Waipounamu Collective had been seamless in many parts of the country, some Christchurch users were still reluctant to trust the new provider.
"We're still having people who either access our other services, or who haven't heard the news yet, coming to see us. And when we tell them about the change, people talk about the range of other services [Te Waipounamu's agencies] provide as reasons why they don't want to engage with them," he said.
The change of address in Christchurch had added to the uncertainty, George said.
"Not everyone has ... good access to transport, so it's quite difficult for some people to get to the east side of town... so we've had some clients quite upset over the change of location, or the lack of a central location," he said.
However, Tinirau said clients had been impressed by the new venue.
"The comments we've received from the peer group so far ... walking into the new exchange, are 'well, this is light and it's bright and it looks welcoming, it looks fresh'. So being able to offer something maybe a little bit different than what they've been experiencing for the last few years is really neat."
Te Waipounamu Collective was committed to harm reduction and peer-led services and over the next year it also wanted to expand to meet the needs of a wider range of people who inject, she said.
Plans were being explored for mobile services in Christchurch and improved access in Southland, where people could order online and have supplies delivered, Tinirau said.
"What we know is that Māori weren't well supported previously and so we are gathering more consumer voices on what they feel they need, what would work for them. Then there are different pockets of groups that access, or want to use, needles and not necessarily just people that inject drugs. They could be people that are using steroids that are attending gyms. We've heard of groups that are receiving hormone change medication from overseas and want to acquire equipment, so it's not just the stock standard of what we once knew 30 years ago," she said.
"New Zealand is a leader in the world for ... offering free injecting equipment ... and I think we're now in a world where we do challenge bias and stigma."
In a letter published on DISC Trust's website, executive director Philippa Jones said DISC would continue supplying other harm reduction services, including drug-checking, advocacy, research, screening for Hepatitis C, HIV and STIs across Te Waipounamu and the "low-threshold" DIVO GP Clinic in Ōtepoti/Dunedin.
"While we are no longer the main provider of the needle exchange service in Te Waipounamu, our commitment to people who use and inject drugs and communities remains unwavering," she said.
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