Dunedin’s harm reduction service, or DIVO, lost the contract to operate the South Island needle exchange service last year after running it for more than 30 years.
It led to an upheaval of its resources and confusion from many in the users’ community, and last week Health New Zealand Te Whatu Ora (HNZ) decided to cancel its links to the only GP working in Dunedin and the South Island to specialise in harm reduction.
Advocate Gilbert May said HNZ’s decision shocked the community, and put lives at risk.
‘‘The past few years have seen the deterioration in trust between people who inject drugs and healthcare providers in great part because of destructive, short-sighted and not-consulted decisions.
‘‘No-one as far as we understand has conducted any consultation to the users of the DIVO GP Clinic, nor indeed the wider community, over a decision that will directly and detrimentally affect their health and wellbeing.
The GP Clinic at DIVO had been a cherished and respected service satelliting the New Zealand needle exchange programme, but always independently run by the GPs themselves, Mr May said.
‘‘We people have come to expect poor treatment and stigma in health and other settings. However, it now seems that the GP service, and the current GP Jim Ross is now being treated with the same dismissive and cavalier attitudes we have witnesses in the past few years.’’
University of Otago honorary research fellow Dr Geoff Noller said the removal of an on-site GP would cause major trust issues in the community.
‘‘When we start thinking about services for people who inject and who use drugs, one of the key things is you have to think about trust.
‘‘You have to think about how those people who may have had very negative experiences with health services, for example, are very wary about using those services
... As a consequence they tend to avoid those services even if they are in significant need, right up until the last possible minute when they really do have to do something.’’
Dr Noller said medical services for people who injected drugs had been ‘‘a crucial area of chronic underfunding. When you’re talking about one of the most vulnerable populations in New Zealand, you really have to look really closely at that and say this is a big problem,’’ he said.
‘‘Because of course the downstream effect of not attending to these people’s wellness are significant.’’
Having a free needle exchange service combined with GP health support actually saved the country money down the line, he said.
‘‘When you’re talking about one of the most vulnerable populations in New Zealand, you really have to look really closely at that and say this is a big problem.
‘‘Because of course there is the downstream effect of not attending to these people, this population’s wellness are significant.’’
‘‘At the very least’’ he would like to see the GP service retained.
‘‘The money has been there for the GP, it’s actually there. Where’s it gone?’’
Health New Zealand Starting Well director Deborah Woodley confirmed that in the handover of the needle exchange services to South Island-wide provider Te Waipounamu Collective, the national health body provided ‘‘interim funding’’ for the GP service at DIVO.
This funding expires in June.
‘‘This decision was communicated to DIVO by WellSouth, who were the contracted provider.
‘‘Ngā Kete, the lead provider in Dunedin (part of Te Waipounamu Collective), are actively exploring options to provide and continue a GP clinic service for clients.’’
