The Otago District Health Board wants discussion about transferring patients to rural hospitals when Dunedin Hospital is full, despite being told it is not always an easy or practical option.
Consultant physician Dr Brandon Rae told the board meeting last week that while it was easy to transfer patients to Dunedin Hospital, sending them back to rural hospitals was not quite so straightforward.
Rural hospitals did not accept patients after about 2pm or 3pm, he said. Sometimes, they did not have a doctor on duty at the hospital and usually there was a reluctance to take patients receiving high-cost treatments.
Arranging a transfer took "an incredible amount of time" and he gave an example of a registrar coming on duty in the emergency department, with eight patients waiting to be seen.
"He could not get through that workload if he had to try and send people to rural hospitals."
Several board members asked if better communication was needed between doctors in different hospitals.
Dr Rae said there were "communication issues at all sorts of levels".
He had recently arranged the transfer of a patient to a palliative care facility.
"The doctor receiving the referral gave his consent, but I got rung the following day by a different doctor who was quite irate, because she did not feel comfortable [caring for that patient]."
It was natural human behaviour that if a doctor had one or two bad experiences in attempting to transfer a patient, they would not be willing to keep trying, he said.
Chairman Errol Millar said he had raised his concern after an experience at Dunedin Hospital with a relative, when a junior doctor had not known there was a hospital in Ranfurly.
Dr Rae said "a large number of doctors" came from overseas and might not be used to having rural hospitals.
Board member Dr Branko Sijnja said during the last "code black" at the hospital, Balclutha Hospital had empty beds and he was "not sure" it was that hard to transfer a patient.
It was agreed senior Dunedin Hospital managers would arrange to meet rural hospital managers to discuss the issue.
