Health is an essential service to all people in this country.
Sadly, it has been sorely neglected and overlooked by successive governments. A significant amount of money is spent on consultant fees, repeat consultant fees, ping-ponging between successive governments undoing the work done by the previous government, and then starting again from scratch.
Dunedin Hospital is an excellent example. Both Labour and National governments promised to build an agreed design of a new hospital: both have reneged on their promise, with National now going back to the drawing board to keep costs within an unrealistic budget.
These delays are causing costs to rise even more.
The current hospital already struggles to meet the health needs of the people of Otago and Southland, so any talk of cutting services would significantly impact these health needs even further.
Meanwhile, there are sad stories of nurses not having functioning equipment, broken IT systems, broken equipment, broken heating systems, leaking operating theatres and post-surgical spaces: the list goes on.
The chaos during the recent refurbishment of the Dunedin ICU resulted in massive noise and clinical disruption. It is not realistic to even consider the refurbishment of an old broken building.
Auckland or Wellington wouldn’t tolerate it: why should we in the South?
As a recently retired GP in Wānaka, who took my first tentative steps into the University of Otago Medical School in 1972, I cannot believe what is happening in Dunedin. To not build a full tertiary-level hospital that also operates as a training hospital for medical, nursing, allied and public health students is unthinkable, not only in terms of health services available to the wider community, but also in terms of the impact on the medical school, the university, Dunedin and the broader region.
Why would aspiring health professionals want to gain their degrees through a second-rate hospital? Why would medical specialists want to work in a second-rate hospital? And why would world-class public health researchers want to carry out their research in Dunedin?
I cannot stress how important it is for the Upper Clutha community to have access to a full tertiary-level hospital to provide backup for our local health providers and hospital staff at Dunstan, who all do a wonderful job managing on minimal resources.
They deal with medical issues that can be managed locally, thereby saving admissions to the tertiary hospital; they treat people locally to keep people close to their support networks and communities; and when they need to, they investigate and refer patients to secondary services. Most surgery needs to go to a tertiary hospital, and that tertiary hospital must be able to meet the needs of the Upper Clutha community.
General practitioners throughout New Zealand are under the pump. The funding model for general practice, like that for hospitals, is so broken that many practices in the country have had to close down as they are no longer economically viable.
Local GPs need the new Dunedin Hospital to be a high-functioning, tertiary-level hospital that they can rely on. Without such a hospital we are at risk of losing practising GPs.
We are always going to need a reasonably accessible tertiary-level hospital to provide advanced care for complex medical cases, and it is unlikely any government would build such a hospital in a rural area. We certainly need more publicly funded health services locally, including modern imaging, acute care treatment, more fracture clinics and many other services.
If more treatment and investigative procedures could be undertaken locally, fewer referrals would need to be made to the hospital specialists. Those that were, would be of better quality with up-to-date imaging.
Currently, 54% of referrals to the southern hospitals are declined (the highest decline rate in the country) because they say the referral "does not meet established criteria". We believe such rejections are often based on hospitals not having the capacity to see patients within a prescribed timeframe.
Any scaling down of the new Dunedin hospital could see even more referrals declined.
To date, all we have seen from the government is political failure, severe short-sighted vision and broken promises. My request is simple: rebuild the hospital according to the original design specifications.
Nothing less is acceptable. Southern communities deserve a new, fit-for-purpose hospital to meet their current and future health needs.
— Dr Brigid Loughnan is a retired GP and a Health Action Wānaka committee member.
