News Video | Policy | GPs | Hospitals | Medical | Mental Health | Welfare | Search

 

Special Medical Areas

29.11.06.
Special Medical Areas

Current moves to end the special medical area status in the West Coast's Ngakawau and South Westland districts again highlight the failure of successive governments, Ministry of Health, and local DHB corporate managers to understand the principles upon which these areas were established around New Zealand.

It has long been recognised that the earliest possible treatment of health problems is not only beneficial to patients but is also economically advantageous in that it often prevents more serious conditions developing which often cause great suffering and cost far more to treat at a later stage. So the s.m.a.s were established in many low socio-economic areas to remove the barrier of cost to people consulting their doctors at an early stage.

While some progress has been made in reducing the cost of going to a doctor this still remains a barrier to a great number of people especially when some doctors will only discuss one medical problem per consultation when the patient may have several problems, and when extensive travel to the doctor's surgery is involved.


It is remarkable to note, therefore, the continuing shining light which the Hokianga s.m.a. provides in terms of a rural medical model. The Hokianga provides free services for approximately 9,600 people via the Rawene Hospital/Health Centre and no less than nine local clinics scattered throughout the district. They also have eight community nurses, psychiatric district nurses and support workers, home support services and basic dentistry working from five school dental clinics. . Even prescriptions are free apart from manufacturers' premiums. (more information on their website www.hokiangahealth.org.nz).

While there has been some dispute about the costs per head compared to the rest of New Zealand, some years ago it was established that the cost per head in the Hokianga was actually less than the average for New Zealand overall.

It is also pertinent to mention that while successive governments have decimated the rural hospital network (over 80 local hospitals closed over the past 25 years) a Canterbury Area Health Board report in the 80s demonstrated that the costs of up providing rural health services via local hospitals was vastly cheaper than when services are centralised. In the early 90s small Otago rural hospitals ran on total yearly budgets of around $400,000 - the same as some DHB ceos get as yearly salaries now.

So why are the West Coast bean counters now moving to end the two remaining s.m.a.s here? Presumably, like everything else they do, this will be at the direction of the Ministry of Health who obviously believe that one size fits all. During my year on the West Coast DHB board I recall talking to them about the legendary Dr. Smith who entirely on his own launched the Hokianga health service which ultimately led to the present free service. They were not interested.

Highly relevant to the West Coast is the Buzz Burrell scheme to provide a version of the Hokianga service which, by eliminating unnecessary management duplication and disorganisation would have saved enough money to provide free health services to everyone in the Reefton/Inanghua district. My fellow board members weren't interested in that either.

It is an appalling indictment of the supposed community representatives on the West Coast DHB that they will undoubtedly knuckle under to the bean counters when they are presented with the ultimatum to approve the ending of the Ngakawau and South Westland s.m.a.s. As long as the Hokianga system survives - and I have a copy of Buzz Burrell's Reefton/Inangahua scheme! - the sound common sense of removing all cost barriers to health care will remain a live issue.

The refusal of the authorities to apply the sound principles of the Hokianga model elsewhere can only lead to the conclusion that eventually, and under whichever government feels the time is right, the ultimate aim of the politicians is to entirely privatise health care.

David Tranter 46 Woodstock-Rimu Road, RD3 Hokitika.

ENDS


© Scoop Media

 
 
 
Culture Headlines | Health Headlines | Education Headlines

 


Howard Davis: Emerald Fennell's Promising Young Woman'


The Guardian needed not one, but three reviews to do justice to Fennell's unsettling approach, which indicates exactly how ambiguous and controversial its message really is. More>>


Howard Davis: Jill Trevelyan's Rita Angus

Although Angus has become one of Aotearoa’s best-loved painters, the story of her life remained little known and poorly understood before Jill Trevelyan's acclaimed and revelatory biography, which won the Non Fiction Award at the Montana New Zealand Book Awards in 2009, and has now been republished by Te Papa press. More>>

Howard Davis: The Back of the Painting

Painting conservators are the forensic pathologists of the art world. While they cannot bring their subjects back to life, they do provide fascinating insights into the precise circumstances of a painting's creation, its material authenticity, and constructive methodology. More>>


Howard Davis: Black Panthers on the Prowl

A passionate and gripping political drama from Shaka King, this is an informative and instructive tale of human frailty that centers around the charismatic Chicago Black Panther leader Fred Hampton, who was murdered at the age of twenty-one during a police raid. More>>

Howard Davis: Controlling the High Ground

Stephen Johnson's raw and angry film not only poses important questions with scrupulous authenticity, but also provides a timely reminder of the genocidal consequences of casual bigotry and xenophobia. More>>

Howard Davis: Dryzabone - Robert Conolly's The Dry

After the terrible devastation caused by last year’s bushfires, which prompted hundreds of Australians to shelter in the ocean to escape incineration and destroyed uncountable amounts of wildlife, The Dry has been released during a totally different kind of dry spell. More>>


Howard Davis: Hit the Road, Jack - Chloé Zhao's Nomadland

Nomadland is perhaps the ultimately 'road' movie as it follows a group of dispossessed and disenfranchised vagabonds who find a form of communal refuge in camp sites and trailer parks after the economic contraction of 2008. More>>

 
 
 
 
 
 

LATEST HEADLINES

  • CULTURE
  • HEALTH
  • EDUCATION
 
 
  • Wellington
  • Christchurch
  • Auckland