In Kaitaia and the Hokianga the ratios were 1.45 and 4.87, one bed per 689 and 205 people respectively.
-In contrast to other regions, no surgical services were available at the hospital serving the Mid North population, the shortfall in beds and surgical services meaning many patients were needlessly admitted to Whangarei Hospital. Failure to provide services locally had uncounted economic and social costs.
Community hospitals had an important role in the delivery of care in because of topography and distance to base hospitals, reducing the need for more expensive base hospital beds, thereby reducing overall health service cost and concerns such as bed-blocking; playing a more effective role in intermediate care, recovery and rehabilitation, transition to independent living, respite and palliative care, all enhanced by patients being closer to their families, community and allied support services; reducing social isolation and the cost of family and social support incurred by providing care at the base hospital, which was never accounted for in models of care.
"This includes time off work, travel expense and accommodation because family members are too far from home. Or they simply can't afford to make the trip," the group says.
"Travel is an increasing economic impost on all citizens. Providing services closer to the population centre will reduce those costs." There were also unaccounted health costs due to added morbidities in patients failing to get timely access to care.
-By the DHB's own admission (Mid-North Health Services Review, Sept 2009), BOI Hospital was not fit for the purpose of meeting future health needs. Issues with the site and facilities included ageing plant and facility built for a previous era of hospital care; it was likely to be hugely energy-inefficient; it was not likely to meet current earthquake standards; the site had poor access off a heavily-travelled main highway limited to one lane in each direction at the top of a blind hill.
For safety, and to accommodate increasing traffic flows, any access off the highway would require four lanes. It was difficult to see where alternative access could be gained without significant cost.
The site was constrained and highly contoured, limiting future building development and parking requirements, while recent flooding in Moerewa had seriously restricted access from the north. Accidents on the northern bridge approach to Kawakawa had similarly closed off access for periods of time.
There would be little scope for or interest in private partnerships at the current site.
-Accessibility to hospital services had been compromised for the majority of the population due to population shifts. Population in the Mid-North continued to shift north, so Kawakawa was no longer demographically central.
"In response to public criticism concerning a 2009 NDHB decision to retain hospital services in Kawakawa instead of selecting alternative, more accessible locations (Kerikeri and Kaikohe had been considered), chairman Tony Norman suggested that the board's decision was driven by the requirement to serve the population with the greatest health needs," the group adds.
"However, the data do not support Mr Norman's premise that Kawakawa better-serves the neediest segment of the Mid-North population. Population data indicate that a hospital location near Kerikeri would provide improved access to not only the general population, but would also improve accessibility to the two population segments that represent the highest health burdens, Maori and the aged (65-plus)." The DHB had not rebutted the group's findings, while the accessibility issue would worsen over time as the population shift northward continued.
"Given both the state of the existing facility and growing accessibility issues, the proposed $8 million DHB spend on the refurbishment of the existing Kawakawa hospital facilities is an irresponsible waste of taxpayer money," it adds.
"This band aid solution will result in a refurbished facility that will be functionally obsolete from the start."
