Staff at Kaitaia Hospital did not know anything about it, nor did anyone at Whangarei Hospital’s gastroenterology department.
“All I can assume is that it was a cost-cutting measure - maybe they got a directive from Te Whatu Ora telling them to cut down on locum work - I have no idea.
“But whoever cancelled the clinic did not have any idea what I do up here. There were no arrangements made about what to do with the patients that I follow.”
‘We recognise the hard mahi’ - Health NZ
Alex Pimm, Te Whatu Ora operations director for Te Tai Tokerau, said the Kaitaia clinic would be staffed by a permanent senior doctor “following successful recruitment”.
“Wherever possible, we work to ensure that we use our permanent kaimahi in the first instance.
“We recognise the hard mahi by our locum doctor whilst we’ve worked to transfer this to a more permanent plan. These decisions are made with involvement of relevant clinical and service leaders.”
However, emails between Dr Stein and gastroenterology department staff show they were equally blindsided by the cancellation.
No plan for patients
There was no “transition plan” for the Kaitaia patients, until Dr Stein raised it as a problem.
A senior staffer wrote: “This is news to me. There is no plan at the moment to transition patients, but if this is the decision, we need to make a plan for it somehow… how many patients are there?”
Eventually it was agreed to let Dr Stein continue for a few months while they made a plan.
At his final Kaitaia clinic last week, he was able to hand over his more complex patients to an Auckland locum, who has just started working part-time in Northland to help two doctors on staff.
However, Dr Stein worries about his patients - and the extra workload on Northland’s hard-working, dedicated gastroenterology team, which is already stretched.
“If you’re going to cut services, find out what the impact is going to be before you just cut it.
“The impact in this case might mean more emergency room visits, more hospital admissions, just compounding the work on the gastroenterology staff that’s already overworked.”
Not a money issue
Dr Stein is semi-retired, at least in theory. As chair of Crohn’s and Colitis New Zealand, he has spearheaded national advocacy campaigns for better access to medicines.
Last year, he gave up his private practice to help patients in under-served regions with little access to specialist services.
There is no shortage of demand - he is currently doing locums in the public system in Hawke’s Bay, Rotorua and Invercargill.
For Dr Stein, it was not about the money.
“I can make more money doing two colonoscopies in an hour than I could working a whole day up here and actually managing the patients all month.
“I know all the patients up there. Almost all of them have my phone number and when they have issues they call me directly.
“I get paid to work two or three days up there, but when I leave, I cover those patients 100 percent.”
Patients ‘devastated’ by news
His Far North patients are gutted - more than one broke down in tears at their last appointment with him.
Mark Delacey - whose wife Christine suffers the crippling inflammatory condition Crohn’s Disease - said Dr Stein’s care has been “life-changing”.
“He would ring on the weekend, just to see how Chrissy was progressing. So when we heard he was no longer coming here and he would no longer be Chrissy’s specialist.... well, to me and Chrissy, it’s devastating.”
Delacey is waiting for an appointment with a gastro specialist after being referred by Dr Stein - but no-one has been able to say how long he may wait.
Jennifer Gay - who has ulcerative colitis - said Dr Stein called her every day to check on her condition after she was sent home after surgery to remove her colon.
“I would have died if he hadn’t said ‘go and get a blood test and get down to Whangarei Hospital’ because I had septicaemia.
“My wound, I’d had my entire insides pulled out and put back in, was completely infected. It was a pus factory.”
Gay, who lives in an isolated coastal community on the Karikari Peninsula 30 minutes drive from Kaitaia, gets infections relatively frequently.
“I’m pretty stoic, but if I don’t get onto it quick, it can get to the point where I’m in ED, screaming like a cat.”
Northland’s GP shortage made the situation more scary, she said.
“My partner has to travel five hours to see a GP because there’s no-one taking new patients in Kaitaia.”