Need for timely healthcare

Health funding continues to be increased most years, by governments of all hues, and yet the problems remain.

In a strange set of events, Health Minister Jonathan Coleman released the latest quarterly health target results showing the emergency department target has been met for the second consecutive quarter. District health boards are continuing to improve their performance on the Government's health targets, according to Dr Coleman.

On the same day as the release from Dr Coleman, the Otago Daily Times ran a page one story saying patients have been waiting in corridors in the Dunedin Hospital emergency department as it copes with an influx that is stressing the entire hospital. Dunedin Hospital was at 103% occupancy last Monday. In the previous two weeks, 16 elective procedures had been postponed, three of them because of a sick doctor.

This month, the ED set a record when 173 people turned up on one day the previous week, the most in a single day. Elective surgery was postponed because of pressure on beds. Managers have been attending daily morning meetings in ED. It is understood some were helping out with patients during busy periods, an indication of the commitment of those managers. The next set of statistics to come from Dunedin Hospital's ED are likely to be worse because they will include the full number of flu victims and others suffering from winter ailments.

Across the country, more than 250,000 New Zealanders were admitted, discharged or transferred from an ED within six hours - achieving a 95% target for the second consecutive quarter.

Southern ranked 17th out of the 20 EDs ranked by the Ministry of Health. A day later, a story about dozens of procedures being postponed at Dunedin Hospital followed the patients waiting in corridors item.

All elective surgery set down for last Tuesday was cancelled apart from day surgery and eye surgery. Staff hate cancelling surgery because it is a ''big thing in someone's life'', acting chief medical officer Dick Bunton says.

Even an urgent heart patient's procedure had to be put off. Southern ranked 16 out of the 20 health boards for improved access to elective surgery with all boards meeting or exceeding ministry targets.

Labour sought to make capital out of the ED patients waiting in corridors in Dunedin. Health spokeswoman and former health minister Annette King accused the Government of stretching the health system to breaking point. As a former minister for the sector, Mrs King should have known better. Anyone with a sense of history can look back in time and see Labour has been accused of the same neglect she is now heaping on Dr Coleman.

What is becoming obvious is how the lack of people living south of the Waitaki River is affecting the funding provided to sectors, such as health. When present Finance Minister Bill English was health minister, his rationale for health reforms revolved around people preferring better treatment in a main centre accessed quickly by road or air. This preference was instead of having small cottage-type hospitals in many rural centres.

The argument sounded convincing in 1996 to 1999, but has proved problematic in recent years. The Southern District Health Board is under pressure from Dr Coleman. He has appointed a commissioner to run the board, outside directors have been appointed and a professional outside accountant has been appointed as acting chief financial officer.

These are dire times for health in the South. Dunedin Hospital needs major improvements or even replacing. There is a sense of foreboding within the community about the future role of the Otago Medical School in Dunedin. Existing staff need to be recognised for their commitment to keeping the region healthy, under sometimes extreme circumstances.

Whether the Southern board needs more money to survive will hopefully be identified soon. It may be existing funding needs to be used more wisely. What remains essential is the need for a strong health system where southern residents can rely on getting healthcare in a timely fashion.

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