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The Southern DHB's proposed primary care plan lacks detail and could lead to job losses, health sector unions say.
The newly released plan proposes greater use of new technology to triage and treat patients, and for home-based care and monitoring to become commonplace.
Public Service Association Otago organiser Julie Morton applauded the intent of the plan but questioned whether the cash-strapped DHB had the resources to carry it through.
"Where is the workforce planning to go with these proposed new models of care?''
"They have very aspirational goals they cannot simply just bring in,'' she said.
The DHB report called for an early review of funding levels and contracting, and said "transformational change'' would be required to make the proposed new system work.
Mrs Morton said she feared that was a hint of future job losses.
"There is so little detail and such a huge absence of workforce planning that we just don't know yet - but that is a serious concern.
"At the moment we are already in crisis with not enough staff to do the job and make sure people are cared for properly once they enter the hospital. They haven't even figured out what do about the hole they have already got.''
New Zealand Nurses Organisation Dunedin organiser Lorraine Lobb said the DHB's plan was incomplete and members were awaiting more details of how the proposals would work in practice.
"If services are going out into the community, nurses would have to follow suit ... What they are going to do?
"`Where's your plan?' would be the first question we would ask of the DHB.
"Then we would have some idea what it really means.''
Community-based primary health care had been proposed for 10 years, but the new plan did not explain how this would happen, Mrs Lobb said.
"I guess it's everyone's wish to get everyone out of hospital and treated in their community, but the technology, the people and everything which goes with health care needs to be out there in the community, and there is no clear plan about how that is going to happen.''
The SDHB is holding consultation meetings across Southland and Otago next week to discuss the draft primary and community care action plan.