There is much talk about a new hospital for Queenstown. Tracey Roxburgh talks to the people with the ideas.
For more than a decade, Queenstown and surrounds hospital services have been a near constant topic of conversation.
Progress is slowly being made — the Southern District Health Board has been granted consent for a $6.5 million upgrade of Lakes District Hospital, but that is not a long-term solution for the area’s public health facilities.
Remarkables Park Ltd (RPL), and others, have again announced plans for a private hospital, with room for public facilities and Southern Cross says it is also eyeing up Queenstown — although not necessarily with RPL.
However, there is general agreement the community needs to be realistic about what future hospital services look like in Queenstown — and a full-service base hospital in the resort is not part of the planning.
Many believe co-location of private and public health services is the best alternative, but questions remain as to how that may be achieved.
Southern DHB chief executive Chris Fleming was given two priorities when he arrived almost two years ago.
One of them was "addressing something in Queenstown".
"We’ve clearly got an emergency department in Lakes District Hospital that is clearly substandard, that is clearly not able to meet the requirements of the population ...
"The mandate I was given was that we didn’t have enough time to work through the process to find out what we need for the next 20 or 30 years.
"We needed to get on and do something to make sure we were able to maintain safe and sustainable services on the existing site for at least the next five to seven years to allow us to get through the more robust dialogue and discussion."
The $6.5 million upgrade to LDH gives the board time to look at the bigger picture and the development of a private facility would also ease the pressure.
He believed it "highly likely" only one of the two present private propositions would come to fruition.
"I can’t speculate on which one. I just don’t think the demand and the resourcing capability would be viable to have two competing surgical facilities."
However, that would not affect long-term planning on the DHB’s part for Queenstown — but a full-service, 24-hour base hospital in the resort, or the wider district, would not be an option.
"In a population of 330,000 you would normally only have one 24-7 system, but because we suffer the huge challenges of geographical coverage, we already have two.
"Ignoring money, from a physical ability to resource three 24-7 services across a population of 330,000 people, it’s just not viable."
There were questions over the future of LDH on its existing site, and Mr Fleming said the DHB would have to "think very carefully" about whether continued development there was logical, or whether it should look at other options.
"I think that if we get the [LDH upgrade] under way, I think if we get the private thing off the ground, then that kind of provides us with a really good core to ... say ‘right, what are we going to do in five years’ time?’
"In terms of how we configure the wider health resources, I think that’s a conversation we have to have the maturity across our district to be able to actually, really, have that conversation for the next development."
Dr Hans Raetz has spent the last decade working on plans for a private hospital facility at Remarkables Park.
Key to that proposal is co-location, meaning having specialists, GPs, surgeons and others under one roof, close to the existing Lakes District Hospital and Queenstown Airport for efficient helicopter transfers, with room to grow, and room for the Southern DHB to relocate to, if that is what it wants.
Dr Raetz has worked closely with Remarkables Park Ltd director Alastair Porter, and others, on the proposal — they are now on their 22nd version of architectural plans.
The location was an important consideration, particularly given the DHB had already signalled its willingness to look at options to outsource to the private sector.
Further, he believed a rebuild of Lakes District Hospital, on its existing site, would be unlikely.
He feared a private hospital development in a rural or residential area would not have the ability to "draw the public hospital on side" and was likely to face challenges if helicopter landings or take-offs were required.
However, if Southern Cross entered Queenstown and opted for any location other than Remarkables Park, that plan could be derailed.
"The problem is, if you’ve got one hospital developing, it doesn’t matter where it is — it could be up on the Crown Range — that would preclude any other hospital provider to move in.
"I guarantee you of that.
"If the first one is a cheap solution, going somewhere where you can save a couple of dollars on the land because it suits the private provider, we’re going to be stuffed doing anything else.
"The whole point of doing this was to actually get public and private better services, and not just private ... I’m getting really sick of this ‘we’ll just do something as cheap as possible and do the profit take and walk away from it and everybody’s happy’.
"Well, not everybody’s happy."
In 20 years, Queenstown Lakes district councillor John MacDonald wants to see public and private health facilities "in one place".
However, the community needed to be "realistic" about what future services it could expect, should a private hospital develop and the DHB decamp some of its services there.
"We can have day surgery, we can have some theatres, we can do a lot of stuff that isn’t currently being done here ... but we are not going to have a base hospital in Queenstown.
"In today’s world, that isn’t going to happen and we have to be realistic."
Despite its growth, the district was not big enough to justify separate public and private hospitals and there would always be a need for patients to be transported out of town to, for example, Dunedin Hospital.
However, Cr MacDonald, who is also the chairman for the DHB’s Central Health Network, believed Lakes District Hospital might soon reach its expiry date.
"You’ve got to ask the question, is that where we see the hospital being [long-term]?
"I, personally, have my reservations about that.
"It’s great to see they [the DHB] are spending the money on the upgrade [but] it’s not enough and it’s only going to tide us over for five to six years, I understand, and then something else has to be on the table."
Cr MacDonald believed many of the parties involved in the wider discussion to date had "the ultimate solution in sight", but it was critical they worked together.
"We could sit here and do nothing like we have for the last 10 or 15 years and be in the same position.
"The goodwill of all the parties is needed and, unfortunately, over many years there’s a lot of history involved here.
"We need some people to trust each other and move forward."
Mr Porter said the private provider had worked with his company and others involved in the proposal for a Queenstown health clinic at Remarkables Park for "a very long time" and they would continue to do so.
"But we can’t make them work with us.
"If they don’t want to work with us then we will, certainly, make a major effort to find an alternative surgical hospital [provider] ... but it certainly would be more difficult than difficult if two private surgical hospitals come to Queenstown."
Mr Porter said he was concerned the two private facilities would likely "cut each other’s lunch" and, from a community perspective, momentum on a one-stop-shop medical facility may be lost.
"There are many people in this district who have worked — we’re not the only ones — long and hard for no remuneration to get better medical facilities, so it’s been a hard grind.
"It’s important to keep the discussion positive and try and bring all the medical providers together, if we possibly can, into one location.
"Certainly, I don’t think anybody is trying to make a fortune out of Queenstown getting better medical facilities — everybody I know who’s been associated with it has put their time in for no charge and certainly, as far as Remarkables Park’s concerned, offered sites at below market and on terms that could accommodate the provision of medical facilities.
"People like myself and Hans [Raetz], and many others in the district, are passionate about trying to get the district better medical facilities.
"It would be a great shame if they’re not located together."
- Professional director Andrew Blair, who is working with Southern Cross on establishing an independent surgical hospital facility for the Queenstown and Central Lakes area, declined to comment when approached by the Otago Daily Times.
Population predictions
2011
Queenstown Lakes district average population: 46,612
Queenstown Lakes district peak population: 89,346
Wakatipu: 32,326
Usually resident: 19,150
Visitors: 13,086
Wanaka: 16,734
Usually resident: 9290
Visitors: 5086
2031 forecast
Queenstown Lakes district average population: 67,439
Queenstown Lakes district peak population: 129,901
Wakatipu: 46,817
Usually resident: 29,543
Visitors: 17,274
Wanaka: 20,622
Usually resident: 14,550
Visitors: 6072
• At Queenstown Airport there were 2,140,669 passenger movements to the year ended June 2017. It predicts by 2045 that will increase to 5.1 million a year.
