No dermatologist in Northland – patients waiting eight months for help

Northlanders are dealing with debilitating symptoms while waiting eight months on average for a specialist appointment. Photo / 123rf

Concerns are growing for the mental and physical health of dermatology patients in Northland who are waiting an average of eight months for a specialist appointment.

Some drive from Kaitāia to attend appointments in Auckland privately, while others are asked to travel to Warkworth for clinics after lengthy waits.

Health New Zealand Te Whatu Ora confirmed there is no dermatologist in the region and two professionals are instead travelling to Whangārei and Warkworth to host clinics.

Patients feel as though they have been let down by the system, which is inflicting further mental, physical and financial strain.

Doctors are doing what they can on the front line but say the issue speaks to a wider health system crisis.

Northlanders desperate for aid fork out or face long wait

Kaitāia-based teacher Stacey was diagnosed with psoriasis at 20 and until recently had regularly seen a dermatologist at a medical centre in Whangārei.

“You could always see they were overloaded, but they always did great and were always accommodating.”

Earlier this year her dermatologist advised he would no longer be travelling to Whangārei for clinics and re-referred her back into the system.

She hasn’t heard anything since and has been left with little choice but to seek out help privately and travel to Auckland for her monthly Cicunomab injection.

Having a dermatologist who she saw regularly and was able to validate and understand her made a huge difference.

“Something needs to happen, we can’t have these sectors that exist, but no one is there to run them.”

Cassandra was referred to dermatology after injuring her foot in January this year and struggling with an infection, which she was advised could take up to a few years for an appointment in the public system.

“To hear that we had nobody up here, I was like ‘you’re kidding, like really?’”

After many calls and emails, she finally managed to find an appointment in Auckland – costing her $356.

“To have Auckland as the point of call for anything up north – that’s a huge amount of people that have no access.”

“Up here there’s really a need for one attached to the hospital.”

She was lucky to be able to afford the appointment but said there would be others in worse positions.

“It’s a huge impact on [Northlanders’] life to actually not get support for a skin condition that could be looked at by a specialist and fixed in a short while.”

“Somebody may have to live with something for weeks, months or years because they can’t get the support they need.”

She said it felt as though the system was “going backwards”.

“You go past Auckland and that’s it, the rest of the country is forgotten. Anything out of the metropolis centres is not important.

And shouldn’t we be able to live where we want? Still with the tax that we pay and everything like that, why do we get less service?”

Graeme was diagnosed with psoriasis around 40 years ago when 75% of his body was covered, and said the treatment in Whangārei was “seamless”.

He then lived in England for almost 20 years and started using a prescription injection to manage his skin.

Upon returning to New Zealand, he saw a dermatologist who was hosting clinics in Whangārei until this year.

He received a call from Te Whatu Ora in a relatively short space of time for his new appointment but he was unable to make the travel to Warkworth work; if it was a major need, he would have.

His GP can prescribe the medication for now only because they have no other alternative.

Graeme firmly believed that if he had started his skin journey now, he would have been “completely screwed”.

“My heart goes out to anyone in that circumstance now. Any skin condition is horrible, it’s emotionally draining as well as physically taxing.”

GP calls system failings ‘soul-destroying’

Whangārei GP Geoff Cunningham said an eight-month wait wasn’t good enough and spoke to the “crumbling health system”.

“GPs are trying their best but it does increase the workload not having a dermatology service.”

“We try our best, but it’s becoming soul-destroying.”

Whangārei Hospital emergency doctor Gary Payinda said patients were suffering from problems that could be “easily solvable” if they could get in to see their GP or be quickly referred to dermatology.

He regularly sees people coming to the emergency department (ED) as their last hope for aid.

“If primary care has been allowed to fall down and if there’s horrendous shortages of GPs and specialists and a lack of funding for them, where are the patients going to turn to other than ED?”

Whangārei Hospital emergency doctor Gary Payinda said the ED was seeing patients with severe symptoms due to a lack of dermatology access. Photo / Michael Cunningham

He said it was “tragic” that they were having to admit children with weeping sores and uncontrollable eczema.

Payinda questioned where the Government’s priorities lay when landlords were getting richer and regions were suffering.

“The reality is Northland patients have suffered under a neglectful system for so long that they’re thankful for whatever scraps, no matter how delayed or how reduced.”

Te Whatu Ora group director of operations for Northland Alex Pimm said dermatology was among many speciality services experiencing staffing challenges countrywide.

“Dermatologists are a very small and specialised medical workforce and account for around 30 people nationally [at around 22 full-time equivalent] in the public health system.”

“As there are currently no dermatologists in Northland, consultants from Waitematā have been travelling to Whangārei and Warkworth since the beginning of the year to hold clinics.

Patients with skin conditions are reaching out to the Whangārei Hospital ED as their last hope. Photo / Tania Whyte

Before this, private providers from Auckland would visit every six weeks.”

Te Whatu Ora did not directly respond to the Advocate’s queries about how much notice they had before the providers stopped their service.

Pimm said Te Whatu Ora was taking steps to support the growth and retention of the medical workforce.

One permanent consultant has been employed for 2025 who will travel to Whangārei as part of their regular working pattern.

“We are currently recruiting to fill a second position as well as look at the opportunities for nurse-led clinics in Te Tai Tokerau,” Pimm said.

While Te Whatu Ora has said measures are in place to improve the situation, New Zealand Eczema Association spokeswoman Vanessa Jenkins says there needs to be more help for front-line health staff to deal with suffering patients.

She said those having to wait for an appointment suffer from “massive” mental health impacts and ripple effects on those around the patient.

“Depression and anxiety can be amplified when you have that waiting period, you’ve got all these physical symptoms and all you want is some answers.

That can be massive for everyone [involved].”

Empowering medical practitioners such as nurses, GPs and families with information and tools to help manage while patients wait would be a valuable initiative, she said.

Brodie Stone is an education and general news reporter at the Advocate. Brodie has spent most of her life in Whangārei and is passionate about delving into issues that matter to Northlanders and beyond.