From left: Healthcare assistant Brooke Desmond, practice manager Ange Hobson, registered nurse Marlene Sexton and operations manager Adrian Marsden. Photo / Tania Whyte
From left: Healthcare assistant Brooke Desmond, practice manager Ange Hobson, registered nurse Marlene Sexton and operations manager Adrian Marsden. Photo / Tania Whyte
An all-Māori, nurse-led health clinic is aiming to meet the needs of more than 3000 people without a doctor in Te Hiku.
Te Whare Oranga will open on Tuesday in Kaitāia and is the vision of Māori not-for-profit ANT Trust, in a bid to address the lack of available GPs in the area.
The name of the clinic, meaning The House of Wellness, is based on the principles of hauora Māori or the holistic, whānau-centric approach to healthcare.
ANT Trust social worker Adrian Marsden (Ngaitakoto, Ngāti Kāhu, Te Rarawa) was the key driver of the initiative and said the whakapapa (history/background) of the clinic was in response to her team’s experience of the Covid-19 pandemic.
“It started when our CEO Hone Harawira started Taitokerau Border Control (TBC) to protect our vulnerable kuia and kaumātua from being infected by people from outside the area,” Marsden said.
“We then fell into it [working in healthcare] by using our whare [office], Mana House, and our voucher system to work with the district health board and Kaitāia Hospital to hold a vaccination campaign.”
Marsden said it was then that they heard stories from whānau about how their health needs were not being met.
“So when the restrictions lifted and things settled, Hone asked if we should go back to ‘business as normal’.
“I felt that we’d come too far to stop now and we already had the relationships, so that’s how it started.”
Mangōnui resident Kylie Wood said she moved to Te Hiku for a teaching job in June 2022 and had been unable to register with a doctor.
Her only option had been a three-hour round trip to Kaitāia Hospital, which often meant relying on others to drive her and waiting for hours to be seen.
Not wanting to be a burden on her friends, Wood said it had meant she’d left an injury go unchecked and had just “sucked it up at home” when unwell.
Because she didn’t have a doctor, she had to ride out a case of probable strep throat for a week and hoped she didn’t get pneumonia.
“I think I also broke my finger about eight weeks ago at netball, but I couldn’t get it checked and, by the time a physio saw it a few weeks later, it was pretty much too late to fix.”
Wood said that, compared with other whānau she knew who lived remotely, she felt relatively lucky and didn’t know how they would manage under such isolated circumstances.
In order to set up a health clinic under the Primary Health Organisation (PHO) framework, health providers must have 250 enrolled clients, two doctors and a clinic.
Marsden said Mana House would be transformed into the new clinic and they were on target to have the required number of new patients enrolled by next week.
Te Whare Oranga would also be supported by an all-star medical team including Kaitāia GP Dr Lance O’Sullivan, Te Aka Whai Ora (Māori Health Authority) chief medical officer Dr Rawiri Jansen and Kaitāia Hospital clinical lead Dr Joel Pirini.
Jansen and Pirini would act in advisory roles, while O’Sullivan would offer remote virtual assistance via his MaiHealth telehealth consultations.
The MaiHealth founder said he had been operating virtually for the past 6-12 months, predominantly in Māori communities, supporting other health providers.
He said this was the only all-Māori, strictly nurse-led model with no doctor physically on-site he knew of. He believed it had the potential to be a model for others in terms of breaking down access barriers in rural communities.
Kaitāia doctor and 2014 New Zealander of the Year, Dr Lance O'Sullivan, will be providing Te Whare Oranga with telehealth consultations through his MaiHealth medical service.
O’Sullivan has recently returned to Kaitāia Hospital’s after-hours GP clinic, where he sees “so many people who can’t register with a doctor”.
“These people have important health needs, so facing decisions to travel to Auckland for repeat medications are decisions people in the Far North should not have to deal with.
“I’ve been doing this for a wee while now and the reality is, if we can’t offer a traditional service, the next best option is to offer a hybrid service of a nurse supported by a doctor.”
The main reason behind the high number of patients without a doctor in Te Hiku was GPs being unable to take on new patients.
Jansen (Ngāti Raukawa) confirmed many existing providers were struggling to build additional capacity and were therefore rightly reluctant to take on more patients if they couldn’t provide a complete service.
He said a combination of complexities around getting a full range of services, the current funding arrangement, plus workforce shortages, was creating a difficult environment to get the appropriate healthcare needed in rural areas.
Te Aka Whai Ora-Māori Health Authority chief medical officer Dr Rawiri McKree Jansen. Photo / NZME
“This is an important kaupapa because the Far North very clearly needs additional hauora oranga services and there is a clear intention from Māori health providers to meet the needs of their communities,” Jansen said.
“This is essentially filling a gap where there is a need, so this is a really courageous commitment to do the right thing by the community.
Harawira, the chief executive of ANT Trust, was pleased to see the clinic up and running and able to provide a much-needed service for whānau.
He said the initiative wasn’t about competing with the other health providers, but complementing their current offering and taking the pressure off an already burdened health system.
“We want to take this away from just being a clinic, it’s a whole hauora regime, where the medical side is just one part of it,” Harawira said.
Hone Harawira at his home in Awanui.
“It’s about understanding the whānau, knowing who they are, the things they do and their lifestyle.
“Through ANT, we know everybody up here and often it’s the case that there are other ways in which they can be helped.”
Enrolments for Te Whare Oranga are currently open to anyone in Te Hiku not registered with a health provider or GP.
To enrol or to find out more, visit Mana House at 60 North Rd, Kaitāia, or call 027 304 2111.
