Editorial - Tuesday March 4, 2014

Peter Jackson, editor, The Northland Age

If the title of New Zealander of the Year is designed to recognise someone who has made a tangible, positive difference for the people of this country, then Kaitaia GP Dr Lance O'Sullivan was an inspired choice in 2014.

Dr O'Sullivan has been responsible for something of a sea change in the way some of the less advantaged people in a far-flung, generally poor community make use of primary health services that, for whatever reason, have not always been easily available to them. Whether or not they should have been taking greater responsibility for themselves and their dependents before he and his family arrived is irrelevant; the fact is that he has opened some very positive doors for a lot of people who had been missing out, and the benefits of that will be reaped exponentially as time goes by.

It must be said that Kaitaia has long enjoyed very good primary health services, courtesy of a string of skilled, committed general practitioners, many of whom went and go much more than the extra mile to care for patients whose needs went and go beyond the purely medical. Work as a rural GP is probably not the easiest career option even today, but in times gone by, in a community like the very Far North, it called for an extraordinary degree of versatility, patience and stamina. That load has no doubt eased over recent years, thanks in no small part to the perception that non-specialists can't be trusted to do a specialist's job. The Far North experience over several generations gives the lie to that, but these are more risk averse times, and the days of a patient being left to thumb through the magazines in the waiting room while their GP hared off to deliver a baby at the local hospital have long gone.

We may not be the better for that, but that's another story.

But while Lance O'Sullivan seems to be blessed with more than his fair share of versatility, patience and stamina, he stands apart by virtue of his social conscience, his determination to exercise that conscience by using the skills he has developed as a medical professional, his holistic approach to addressing health issues and his enthusiasm for using modern tools to radically increase his reach into the community.

The Manawa Ora Korokoro Ora (MOKO) programme that was established, as a New Zealand first, in Kaitaia, and now serves some 2000 pupils at 14 schools around the district, as a result of his lobbying of government ministers for the modest funding needed to reduce the Far North's rheumatic fever rate, is a good example of that. Much that Dr O'Sullivan does and espouses isn't necessarily expensive, and it doesn't necessarily require new sources of funding, but it meets real health needs that should have been recognised long before he began agitating.

It has not been difficult, in recent years, to find people with the ability to do something to agree that too many Far North children were suffering rheumatic fever, a potentially debilitating, life-shortening disease, but it was the Kaitaia GP's refusal to take no for an answer than finally resulted in action. The routine swabbing of sore young throats is now taking place far beyond Kaitaia, and many, many children and families will have good cause to be grateful for that as time goes by.

Last week's launching of the vMoko programme at Te Hapua was a natural extension, perhaps, although again no one seemed to have thought of it until Dr O'Sullivan, local organisations and an app designer got it going. Like all good ideas this is a simple one - children will be routinely examined at school, the resulting data being dispatched electronically to Dr O'Sullivan's practice in Kaitaia.

When needed, problems such as skin infections will be photographed and sent to him for diagnosis and treatment. If necessary those images will be further referred by him for a higher level of diagnosis.

The major benefit of that lies in the potential to identify and treat illness early, rather than allowing it to worsen to the point where families finally have to face up to the need for a major excursion to Kaitaia. And major it can be. Nipping around the corner to see the family doctor is not an option for many people, and the time and cost involved in seeking treatment the old-fashioned way can pave the way for a minor ailment becoming a major one.

For all that people of a certain age might decry the relatively recent explosion in communication technology and the uses to which it is put, the vMoko programme is a glorious example of how that technology can be put to good use. It is a wonderful extension of the tele-medicine capacity now widely available at hospital level, and enables the skills of any medical professional to be put to much more effective, not to mention cost-effective use than does the traditional method of waiting for the patient to front up at the surgery.

The naming of Dr O'Sullivan as the 2014 New Zealander of the Year suggests that those who conferred that honour recognise that what the man is doing in the very Far North can and should be replicated elsewhere.

His predecessors as New Zealander of the Year - Sir Ray Avery, whose interocular lenses are expected to restore sight to millions of people blinded by cataracts, scientist Sir Paul Callaghan, Sir Richard Taylor (of Weta Workshop fame), and scholar, anthropologist, writer and environmentalist Dame Anne Salmond - were recognised for achievements that went far beyond one small rural community, and it seems reasonable to expect that the latest addition to that illustrious order will too.

With the cost of health services rising every year, not least thanks to technological advances, it is vital, in small communities and a small country, that ways be found to extract the greatest possible value from every taxpayer dollar, and Dr Lance O'Sullivan is clearly very good at doing that.

It does not seem to be extra money that is needed as much as a fresh way of looking at what can be done with what is available, and making the best use of the increasingly sophisticated resources that are at hand.

Whatever the future brings, Lance O'Sullivan, with the support of his wife Tracy and their family, brought (more) great credit to the Far North last week, even if we can't claim them as truly being our own.

The challenge now might be to keep him out of politics, which has a history of beating bright young minds into conformity.

This is one inspirational couple who might do more good from outside the tent, and even if he remains in Kaitaia, which hopefully he will, there is no reason why the doctor's ability to address social and medical issues from a new angle cannot benefit the country as a whole.

And is this the honours pinnacle for the Maori of the Year (2013), Public Health Champion and Sir Peter Blake Trust leadership award winner? Probably not.

Three of his predecessors as New Zealander of the Year were knighted before receiving that honour, and Anne Salmond was named a Dame Commander of the Order of the British Empire in 1995.

It would not be at all surprising if a Kaitaia GP was also knighted in the not too distant future, although his patients are unlikely to ever call him Sir.