Lack of 24-hour care addressed

Aspiring Medical Centre GP Fiona MacLean. PHOTO: MARJORIE COOK
Aspiring Medical Centre GP Fiona MacLean. PHOTO: MARJORIE COOK
Why can’t Wānaka’s GPs fill the 11pm to 8.30am gap in after-hours healthcare? Aspiring Medical Centre GP Dr Fiona MacLean responded at a recent health forum in Wānaka. Marjorie Cook reports.
Wānaka GPs are battling burnout. 

The town’s two medical centres have been fighting to recruit, train and retain staff.

Primary carers are experiencing growth in Wānaka patients and the presentation of increasingly complex mental health and aged care cases.

And GPs feel vulnerable attending emergencies and the drunk and drugged in the small hours.

These were some reasons why GPs had decided two years ago not to be on call between 11pm and 8.30am, Dr Fiona MacLean of Aspiring Medical Centre says.

The medical profession’s issues existed pre-Covid and have continued post-Covid, as the population continues to boom.

"That [24-hour cover] is something that we have tried so hard to do ever since I have been here, and that is 12 years. But it has been going on a lot longer than that.

"We sat down and discussed it. Interestingly, money is not a factor in it. We talked to clinicians who work after hours and there are common themes that come out. 

"One thing we keep hearing is our day jobs are undoubtedly getting harder, more complex, the needs are higher, and our patients deserve us to be on top of [our] game.

"It is very hard to expect people to work a day shift, and be good doctors, then work a night shift, then another day shift. It is just not safe for patients," Dr MacLean told a packed health forum in Wānaka on March 14.

"The other thing that comes up is burnout. We don’t want to burn out our staff. We want them to keep working, we want to retain them and we want them [to] be happy to be here."

Wānaka GPs also felt vulnerable working alone late at night and wanted funding so more staff could share the after-hours work load, she said.

"You don’t know what you will be called out to at 2am. You don’t know what you will meet at the medical centre.

"It can feel very overwhelming and you wonder, how am I going to do it when I only have two hands?

"In an after-hours situation you can be suturing a wound at the same time as the phone is going off. It is really difficult."

As a female practitioner, she had felt fear attending calls to sick patients who were intoxicated or had taken drugs, Dr MacLean said.

For some, Wānaka presented a daunting workload, a high cost of living and required a clinical skill set that did not suit all freshly qualified GPs, she said.

She voiced support for a small hospital in Wānaka and an increase in mental health services.

After-hours urgent care could not be solved by GPs alone, she said.

Forum facilitator Simon Telfer, the chairman of the Wānaka-Upper Clutha Community Board, said Wanaka’s current population of more than 17,000 could be expected to rise to at least 23,000 permanent residents by 2033, or 33,000 residents, depending on which projected growth model was relied on.

He noted more aged care facilities were being proposed for Wānaka by Northbrook and MetlifeCare, which would increase the demand for aged-care primary health services.

Dunstan Hospital clinical director Dr Jonathon Wills said Wānaka’s healthcare needs were changing as the population grew. 

Charities such as Dunstan Hospital and St John were carrying the unfunded burden of Wānaka’s late night emergencies.

Dr Wills called for central decision makers "to fund a system that’s not reliant on a sole practitioner overnight".

 

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