Don't compromise maternity service

In normal circumstances I probably would not address Kate Joblin's editorial on maternity services (March 28) in this column. I'd write a letter or an email. In fact, that is exactly what I did - write an email in reply to hers in which she made the same objections to my published letter (March 23 ). I don't care to use this forum for to-ing and fro-ing but the issues Ms. Joblin (whom I regard as a friend and not as an adversary) raised when she took our correspondence public deserve a public response.

Kate Joblin both overstates and understates my contribution and my role. My letter (March 23) was written in support of councillors Bullock, Solomon and Stevens who had raised objections to the inadequacies of community consultation on the maternity services issue. The credit for their calling this to attention belongs to them, not me. I did take the opportunity to highlight the necessity for participation by women of child bearing age, and in particular, Maori women. It is the economically disadvantaged, among whom Maori are over-represented, who will bear the primary burden should the service be regionalised.

While Kate's reply to the critics of this process lists (for the first time, to my knowledge) a number of community meetings, she also acknowledges that thus far, attendance by Maori women has been slight.

Kate cites me as a critic of the consultation process. It's a title I'd gladly accept providing it is understood that a critic is one who stands disinterestedly aside and examines data to come up with a view that may enlighten. To do this task properly requires admission of bias. I am biased.

I am biased in favour of this city and of its continued progress and of its maintenance of a civil polity providing services equitably, fairly, for our common safety and prosperity.

To insure that future, we need to question thoroughly and as tough-mindedly as possible, this proposed diminution of our local maternity services.

To share what I learned about the consequences such a move might impose on the wider community, I forwarded Kate an article sent to me entitled "Mothers, Babies and Communities", published July 2002 in Canadian Family Physician.

The several authors include Michael Klein, MD, professor of family practice and paediatrics, chair of the maternity committee of the College of Family Physicians of Canada and Jan Christilaw, MD, president of the society of OB/GYN of Canada.

Canada faced cost-cutting measures at behest of the central government. Centralisation appeared a good solution for reasons of efficiency.

The authors however, point out that while the short-term results may be attractive, the long-term consequences amount to a death spiral for communities involved. Medically, the number of premature infants increases as does the number of maternal and newborn complication. The downstream effects are serious and include a succession of losses including departure of midwives and paediatricians and other specialists.

The secondary services across the board are successively weakened and disappear. It takes no special foresight to predict that businesses and our entire economy will suffer to a degree that may prove unrecoverable.

Everyone needs to read that article and I'm willing to make it available upon request.

After that we need to get together and plan how we can best respond in order to save our hospital and our city.

Kate Joblin is in a thankless position and has my sympathy. I believe she's well intentioned but as chairwoman of the DHB she is ultimately carrying the water for a central government policy.

The stated crisis of recruitment of OB/GYN specialists is no more than a smokescreen cover for plans made long before this year. If the proposed shift of services is carried out we'll all have a recruitment crisis, because attracting people to come here will be impossible; living here as a young family will be untenable.