Rural hospitals in spotlight

Existing Southern DHB services. ODT graphic.
Existing Southern DHB services. ODT graphic.
While proposals for Queenstown health services are hitting the headlines, what might be offered at all rural hospitals in the Southern area in future is also under the spotlight.

Rural hospital services have been under consideration by the Southern District Health Board and its predecessors for some years now, with the aim of providing future care which meets need and is clinically and financially sustainable.

And, as former board chairman Errol Millar put it, it is not a simple matter of looking at the total money available, dividing it by the number of people and "sprinkling it around".

The future needs of the various populations needed to be considered, along with such matters as their socio-economic status.

The board has given priority to addressing Wakatipu services but behind the scenes, all rural hospitals have been required to conduct a serious self-examination and consider how they might adapt in future.

The board, faced with an ongoing multimillion-dollar deficit, this year expected to be around $15 million, is required to break even by 2013-14.

That requires it to find ways of delivering all future services as economically and consistently as possible, while still providing the required care.

The board spends about $34 million a year on six rural hospitals.

In its recent rural hospitals' capacity review, consultants Cranleigh Health concluded the existing set-up was inconsistent and artificial boundaries between the various levels of health care led to "inefficiencies in both cost and services for smaller rural populations".

It found hospital bed numbers were adequate until 2026 and could be reduced by treating more people in the community.

Health Minister Tony Ryall, who has not ventured a public opinion on the suitability or otherwise of the Queenstown proposal, has favoured development of integrated family health centres (IFHC) to go with his mantra of community treatment which is "better, sooner, more convenient".

These so-called one-stop-shops of health care are designed to deliver community health care in one place, close to home.

Asked whether the Queenstown concept, which would combine hospital and community care at one site, had gone further than others and if this was a direction he supported, Mr Ryall said a non-prescriptive approach had been taken as to what constituted an IFHC.

Feedback had been that this position was contributing to confidence that change would be clinician and sector-led, the Health Minister said.

In its paper on models of care for rural services, Cranleigh warned there was no single best way to integrate services.

Transition would not be simple and would require "new and enhanced relationships between funders, providers and communities, agreed agendas and outcomes, and it will take time".

- elspeth.mclean@odt.co.nz

 

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