Health is a field in which there will never be enough money, thanks in large part to constant innovation in terms of drugs and procedures, none of which come cheap, but that isn't the problem in Kaitaia.
Those who have provided the town's primary health services for many years are getting older, some having retired or died, and replacing them has proved problematic. That situation is hardly unique to the town's primary health service, but the ramifications hardly bear thinking about.
Doctors, we are told, are not keen to come to Kaitaia, if for no other reason than a national — and international — shortage gives them other, more attractive options. And if doctors don't want to go there, neither will other people the town needs. A lack of even basic medical services makes it more difficult to attract people and investment, the start of an alarming downward spiral.
Anyone who is thinking about moving to Kaitaia now is being told that they will not have access to a GP. They are being advised to maintain contact with the GP in the community from whence they came, wherever that might be. Who would want to move to the Far North under that arrangement?
There were problems even before the announcement that the GPs were closing their doors to new patients. There is no criticism of those who have served the town in the past, or do so now, but a constant stream of locums and short-term contracts is far from ideal, particularly in general practice. The effective delivery of primary health services is built to a large extent upon continuity of care, the ability of the doctor and patient, better still the doctor and whole families, to form a relationship.
That has pretty much come to an end in Kaitaia, and does no favours to the patient or the doctor.
There is a bigger health issue in Kaitaia, however, one that casts the politicians who could provide a solution in an even poorer light. The town's 92-bed Switzer Residential Care, which provides rest home and hospital beds, and a secure dementia wing, is in real trouble thanks to utterly unrealistic funding and immigration policies that are compounding its increasingly dire plight.
The situation has reached the point where general manager Jackie Simkins cannot rule out the possibility that the home might have to close, as some in other parts of the country have already done, because immigration rules are making the recruiting and retention of staff needed to meet the required standards of care impossible.
Now the home is no longer accepting anyone who doesn't have a GP. Where will these people go? Kaitaia Hospital. Unlikely, and certainly not long-term. A home in another part of the country? Perhaps. If they can find one.
The latest insult to aged care in Kaitaia was delivered earlier this year when the DHB graciously granted Switzer a risible funding increase of 0.43 per cent, supposedly to enable it to compete against DHBs, whose registered nurses had been awarded pay rises of 9.5 to 12.5 per cent. Not surprisingly, that has not stemmed the flow of RNs from aged care to DHBs.
For Switzer, it didn't even cover the additional cost arising from this year's $1.20 increase in the minimum wage.
That situation makes aged care ever-more dependent upon immigrant staff. Registered nurses have just been added to Immigration's skills shortage list, which should make recruiting overseas easier, but that long-overdue concession has not been extended to others, such as health care assistants, without whom Switzer struggles to function.
Switzer is now warning the Northland DHB that unless something changes, it will be unable to provide the standard of care that the Ministry of Health demands. What a shambles.
The difference between the GP crisis and aged care funding/staffing debacle is that Northland's MPs cannot claim to have been unaware of what was and is happening. The only one who has made any effort to address the staffing issue, as far as this newspaper knows, is National's Matt King, who has likened the experience to bashing his head against a wall.
Messrs Peters and Jones have been apprised of the situation, and, as far as this newspaper is aware, have done nothing. Mr Davis' response, more than once, in terms of health care assistant Juliet Garcia's predicament — after 12 years at Switzer, and despite having gained qualifications that until 2016 would have entitled her to apply for residence, she will be told to leave the country in July, dropping her employer into yet another staffing hole — has been to say that she and her employer know what she must do to resolve the situation.
That is news to Mrs Garcia, to her employer, and to this newspaper, which has been fighting her corner for more than two years.
The Northland Age urged Mr Davis to call on Mrs Simkins earlier this year, when he was in Kaitaia, but he declined to do so. His schedule that day did, however, allow him time to get a hair cut.
Mayor John Carter and Aged Care Association chief executive Simon Wallace have requested a meeting, in Wellington, with Immigration Minister Iain Lees-Galloway, and have been told not to bother. Associate Minister Kris Faafoi isn't interested either.
None of the Far North's political triumvirate have portfolios that touch on health or aged care services, but they do have a proclaimed interest in this district. And Kaitaia is within Mr Davis' electorate, as well as his home town. When it suits, all three are happy to claim Far North citizenship. In this case it clearly does not benefit them to do so.
Any political clout that might have been expected to accrue from their prominence is illusory. Their collective authority means diddley squat.
The best we can hope for is that their eyes will be opened next year, when they will be seeking to win another election.
By then it will be too late for some people. And any interest on their part will be cynical in the extreme.
