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Home / Whanganui Chronicle

Reasonable standards of care are not being applied in health

By Jay Kuten
Whanganui Chronicle·
22 Apr, 2014 06:14 PM4 mins to read

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Jay Kuten PHOTO/FILE

Jay Kuten PHOTO/FILE

When the Whanganui District Health Board proposed to send 400 pregnant women 72 kilometres to Palmerston North, Michael Laws threw a spanner in the works of that plan, which had originated with a 2009 letter from Health Minister Tony Ryall.

The letter set out a plan for regionalisation of our health services in order to achieve greater efficiency - to save money.

I'll come back to those last two words later as they're descriptive of the crux of our current situation of providing transport for our sick people to speciality care.

The health board management made a colossal political error in starting the Ryall regionalisation with the maternity service.

At the DHB itself, it gave Laws an opportunity to object strenuously that no risk assessments had been done to rationalise the dangerous possibilities inherent in transporting the pregnant women.

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The community mobilised to object, as few matters are so important and so arousing as the health of mothers and babies. By hiring obstetric staff, the management could beat an honourable retreat on maternity, but the regionalisation would otherwise proceed.

I suspect that, as a result, Ryall was put on notice. Dot McKinnon, whose political friendship with Laws was well known, was made Whanganui DHB chairwoman last year, perhaps in the belief it would blunt Laws' opposition.

It turns out that will now be done by the removal van.

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We, however, are left with a DHB and management only too eager to implement the Government's plans to regionalise and thereby "produce efficiencies in health care delivery".

Meaning: save money.

As more speciality services are located away from Wanganui to Palmerston North, the burden falls on the elderly and the chronically or more seriously ill to find transport to their healthcare 72km away.

It's again becoming obvious that central government's blinkered views are combined with the rigid thinking of the local health board to create an unconscionable situation for those who are the most vulnerable.

When the DHB management proposed shifting those 400 pregnant women 72km to deliver, I could only wonder "What are they thinking?"

Patients living 80km away get travel costs reimbursed, so once again the eight missing kilometres that preclude proper provision of support to enable patients to get necessary care is a mere shibboleth, used to exclude.

The Catch-22 is that the public health system, funded by our tax dollars, has a moral as well as ethical and legal obligation to provide reasonable standards of care.

Included in that word, "reasonable" when the care isn't locally available by design is the provision of transport to get the patients to their care.

This brings up two considerations - and it's not only about the buck-passing on this issue between Ryall and the DHB, McKinnon, chief executive Julie Patterson, et al. What happens to all the money that's being saved from regionalisation - can't some of it go to transporting the sick and elderly? Where have all those savings gone?

In all discussion thus far, it is the Wanganui District Council and Whanganui DHB talking.

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What role do Chester Borrows and Tariana Turia, both local MPs and ministers of this Government, play?

How come neither seems to be involved, or did I miss it?

As they're both in the Government, maybe they could have a quiet word with Ryall.

Here's one voice asking them to join the party.

I hope the messages we send our politicians between elections are as well attended as those on election day.

Jay Kuten is an American-trained forensic psychiatrist who emigrated to New Zealand for the fly fishing. He spent 40 years comforting the afflicted and intends to spend the rest afflicting the comfortable.

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