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Geriatrician Leaves New Zealand

Media Release: Age Concern New Zealand

Tuesday, September 6, 2011

Geriatrician Leaves New Zealand

Addressing Age Concern New Zealand, geriatrician and stroke specialist Dr Gerry McGonigal expressed his frustration at the way elderly care and stroke services are arranged and delivered in many New Zealand hospitals. He will return to the United Kingdom this month to resume work as a stroke specialist.

This is bad news for New Zealand, which faces an overall shortage of geriatricians. Geriatricians are specialist doctors trained in the conditions that commonly affect older people and work in the hospital and the community. Dr McGonigal came to New Zealand, along with his wife and four children, five years ago. He led the assessment, treatment and rehabilitation (ATR) service at Capital and Coast DHB for two years before moving into stroke medicine.

"Geriatricians in the United Kingdom aspire to deliver comprehensive care to elderly people in the hospital setting and in the community. In many areas in New Zealand geriatricians only work in ATR services and see but a small proportion of frail elderly people admitted acutely into hospital."

Wellington hospital not having a specialist stroke unit is very unusual for a major tertiary centre in a developed country.

“I could understand a very small hospital not having a stroke unit but this is a main centre. Stroke units were one of the major therapeutic advances of the late 20th century! Without such a unit it is not possible to deliver quality stroke care and this is one of the main professional drivers I have to return to the U.K,” he says.

Dr McGonigal says many New Zealand hospitals are failing to notice and prioritize issues around patient’s dignity. He says older New Zealanders are often uncomfortable about mixed gender cubicles within wards and unisex toilets. Many wards within hospitals also don’t offer ‘protected meal times’ so patients can miss out on being able to eat when a routine test is ordered and the split up-the-back gowns are to be deplored.

“These are high priority issues in the United Kingdom but they’re also important to New Zealanders. When I speak to elderly patients and their carers they have often felt particularly uncomfortable in mixed gender wards and cubicles. Although initiatives within hospitals like 'Releasing Time to Care' are to be applauded we must start to notice the environment in which we are caring for vulnerable elders within acute hospitals”

He says there is commonly a lack of planning around the transition of care from acute hospital back to the community. In many hospitals geriatricians are not directly involved in the acute assessment of frail elderly people and this can lead to inappropriate discharges and a lack of future care planning. Community services are often too slow to respond to the needs of elderly people discharged from acute care.

Dr McGonigal hopes a stronger central direction from Government will be given. A direction that has specific actions and expectations rather than stating general principles and 'sound bites'. A good place to start would be to ensure all acute hospitals have stroke units and can deliver proven treatments such as thrombolysis.

“New Zealand has a fantastic culture. Wellington is a fabulous vibrant city. We have thoroughly enjoyed it here and it has been a great life experience. Professionally I am disappointed that I was not able to develop comprehensive elderly care and stroke services despite the many clinicians dedicated to and interested in these areas.”

Age Concern New Zealand Chief Executive Ann Martin agrees the standard of hospital care for older people needs to be prioritized.

“It’s all about respect. Smiles cost nothing. It’s important people interacting with older people safeguard their dignity.”


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