Two Central Otago GPs have urged caution about the Southern District Health Board's proposal to take some funding away from acute care and redirect it to primary care.
Retired Wanaka GP Dennis Pezaro was one of about 50 people who attended a presentation by the SDHB in Cromwell last week about its primary and community care strategy and action plan, which proposes a new ``hub and spoke'' model of sharing care between primary and secondary health systems.
It would see the capability and performance of the primary and community sector strengthened, and the proportion of SDHB funding for primary care increase from 40% to 50%.
When contacted by the Otago Daily Times, Dr Pezaro said the plan was ``impressive'', but had no detail or costings and was ``very aspirational''.
He said it was unclear if the SDHB would be able to achieve the significant reductions of emergency department and medical admissions it desired.
SDHB executive director, strategic, primary and community, Lisa Gestro said at the Cromwell forum that acute services needed to be freed up to provide only acute care.
SDHB chief executive Chris Fleming said patients were being held on to for ``too long'' in hospitals and more treatment should be moved from emergency care to the primary sector.
More patients should also convalesce in rural hospitals, rather than in Dunedin Hospital.
Dr Pezaro said there was an inequity between urban and rural healthcare, and many rural people would be expecting some of those ``ingrained inequities'' to be addressed by the SDHB, such as rural people in Central Otago having to pay for after-hours emergency care while their urban counterparts did not.
He hoped the SDHB's action plan would contain more detail, and ``real engagement'' with general practice would be needed for it to work.
Dr Greg White, of the Cromwell Family Practice, contacted the ODT saying he was ``extremely disappointed'' in the strategy and there was little focus on improvement or increase in secondary and tertiary services.
``My overall impression is that it was poorly thought out, rushed and the SDHB staff were at times condescending and apparently ignorant of much of primary care and general practice. It was apparent that this strategy is really the SDHB telling primary care groups that the new [Dunedin] hospital rebuild is likely to result in significant secondary service cuts, and we [GPs] are expected to pick up the slack.''
He also criticised the short timeframe of the plan.
``We seem to be on week 15 of this apparently sweeping plan, yet most at the meeting [in Cromwell] have only just been made aware of it, and there is now only six weeks left until action is taken. This is a ridiculously short timeframe to apparently change how hundreds of organisations function and are funded, and on which to base a billion-dollar infrastructure project [the Dunedin Hospital rebuild]. It seems apparent to me this is a plan conceived in the boardroom with little input from those at the coalface.''
Mrs Gestro said at the Cromwell forum that about 275 people had been consulted from consumer and sector groups, and the additional people who attended the Cromwell, Dunedin and Invercargill forums last week took that to about 500 people.
Other health professionals contacted by the ODT said they preferred not to comment yet about the plan until more detail had been released. Some said they were slightly sceptical of the SDHB's promise to ``shake up'' the health system, as they had ``heard it all before'' but no real change had ever been made.
Mrs Gestro said at the Cromwell meeting the SDHB had received similar feedback but it was genuine in its plan to effect meaningful change through the new plan.
The plan would be developed by the end of November and more consultation done in December. The 2018-19 year would be the first year of the plan.
