Doctors and nurses at Lakes District Hospital have concerns about the Southland District Health Board's (SDHB) proposed shake up of Wakatipu health services.
In an anonymous statement emailed to the Otago Daily Times, the doctors and nurses said more time was needed to clarify unanswered questions in the proposal.
Attempts to contact the sender were unsuccessful yesterday, but a staff member at the hospital confirmed the email was a group statement by all the doctors and nurses employed by the SDHB at the hospital.
"We are surprised and concerned that so much progress has been made without the involvement of local hospital doctors, rural hospital or emergency medicine specialists," the statement said.
The SDHB's consultation document "Delivering Wakatipu Health Services in The Future" proposes to refurbish Lakes District Hospital into an Integrated Family Health Centre (IFHC).
The staff statement said the health centre be a "progressive solution" for Queenstown, but only if it was structured correctly.
"We have concerns that many questions are unanswered in this proposal and we believe the community should demand clear answers and commitments," it said.
Staff were concerned Queenstown patients might not have access to free emergency healthcare under the new model.
The SDHB is proposing for patients be assessed by a general practitioner before being admitted to the emergency department. Anyone who could be treated by a general practitioner would have to pay for that medical care.
Other questions included whether the health centre would include a hospital secondary service.
"The IFHC will expand GP services [primary care] and day surgery, but this may actually be at the expense of our acute inpatient beds. This would reduce our ability to treat local people in Queenstown," it says.
It also questioned whether the IFHC was future-proofed for an increase in demand and if it would affect the number of patients having to be transported away from Queenstown.
"We are concerned that the proposal only mentions the expansion of primary care. However, a rapidly expanding population will inevitably lead to increased demand for secondary hospital services ... A primary care model is not sufficient," it says.
By investing in a hospital-level service in Queenstown the need to transfer patients away could be reduced.
The staff also wanted to know if the model had been successfully trialled elsewhere, whether it would work, how much it would cost, and who would pay.
The staff's "vision" for Lakes District Hospital included a hospital-level secondary service and a centre of excellence for rural hospital and emergency medicine.
The staff were keen to point out they welcomed "positive change".
The staff said they would attend and make a submission at a public forum on March 27.
DHB responds:
Regional chief executive Brian Rousseau said the consultation document needed staff and community feedback.
"The DHB will consider all feedback to the current proposal including alternate models of care and public healthcare provision that may not be covered by this proposal," he said.
All emergency patients would be treated free of charge and all primary care patients would be charged "as per the current New Zealand policy".
Queenstown people would not have to pay for emergency medical treatment but a triage nurse would decide whether patients would see a general practitioner or be sent to the emergency department.
Mr Rousseau said the new model would not be likely to affect the number of patients transported away from Queenstown.
Figures released to the Otago Daily Times under the Official Information Act last year showed nearly two-thirds of Queenstown's hospital patients were sent elsewhere for care.
He said the IFHC would contain a hospital secondary service and be future-proofed with expansion options.
He said there was strong evidence from several New Zealand and international practices that the IFHC model would be successful.
"We have developed the proposed model for Queenstown based on the uniqueness of Queenstown," he said.
