A view from rural health Eileen Goodwin | Senior Communications Advisor
R
ural health providers will still be operating at a distance from those holding the purse strings when health undergoes its big structural reform, says Dr Jennifer Keys, a Rural Hospital Medicine specialist at Lakes District Hospital in Queenstown.
“It probably doesn’t matter whether we’re mostly run from Dunedin, or mostly from Wellington. We are all run by organisations that are distant from us anyway, and I’m not sure how much difference it will make.” There are considerable communication difficulties between rural-based providers and their city-based funders.
more effective than others. She says the provision of specialist outpatient services in rural services is ad hoc. It’s possible this will improve under the planned reforms, which emphasises a national health system. “We are very dependent on individuals rather than systems at the moment,” Dr Keys says.
Along with the lack of a specifically rural undergraduate medical programme, it was proving difficult to get PGY1s and PGY2s into rural areas. “The DHBs seem to be hanging on to them in the cities,” she says.
Dr Keys says she hopes that dynamic will change, but it’s uncertain because of a lack of detail about how the new system will operate.
One of the biggest problems is a lack of doctors. Dr Keys says recruitment and retention of doctors for hard-to-staff areas is still not being adequately addressed. Many comparable countries have fully rural medical schools now; New Zealand does not.
“It probably doesn’t matter whether we’re mostly run from Dunedin or mostly from Wellington. We are all run by organisations that are distant from us anyway, and I’m not sure how much difference it will make.”
And she says the uncertain position of PHOs presents a “huge unknown”. She says some of the PHOs have “designed really innovative services”, and some are
Rural immersion as part of the existing medical school programme is valuable and useful, but temporary exposure is not enough, she says.
Dr Keys is presently on sabbatical from her clinical role.
“Sometimes they don’t seem to understand the service we provide, despite the fact they’ve had extensive interactions with us.”
About stop work meetings? Stop work meetings are covered both by legislation and by the DHB MECA. We are entitled to hold two stop work meetings up to two hours in duration on full pay every calendar year. We must give 14 days’ notice of a meeting, and we must make suitable arrangements to cover “essential activities” during the meeting time. We are currently arranging stop work meetings for August to discuss the DHBs’ latest MECA offer. All members, unless agreed otherwise, should attend. Meetings will be held at all major worksites to enable full participation, and zoom links will be provided for those who cannot easily attend. WWW.ASMS.ORG.NZ | THE SPECIALIST
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