Health New Zealand is working on providing permanent 24/7 healthcare cover for the town and its rapidly growing population.
Central Otago Health Services Ltd (COHSL) has been providing an overnight service (with local GPs providing an evening and weekend daytime on-call service) since October last year. The contract came with an understanding that it was for only one year, while alternatives were worked on.
However, the service has been extended until November to allow time for the contract for the new system to be worked through.
The new service being touted at minimum should provide face-to-face after-hours care to walk-in patients from 6pm to 8pm, Monday to Friday, an on-call service from 8pm to 8am, and a face-to-face service available to walk-in patients from 9am to 5pm on weekends and public holidays, and an on-call service from 8pm to 8am daily.
Dr Bernard Fouke has worked in emergency services for over 42 years across the United States, France, Cook Islands and New Zealand.
He said the upgrade sounded good in principal but there were still red flags on what Health New Zealand was defining as after-hours care.
"It depends on whether a person has to pay. In a system where people have to pay to go to emergency services, they will put it off as long as possible and get more sick."
Dr Fouke was also concerned about what back-up and support the practitioners would have in the Wanaka building.
"That’s the big question, what is the depth of specialist back-up? Are they just hanging these GPs out to dry on their own?
"Even if they are an emergency specialist this is a critical part of care, to be able to pick up the phone and call a specialist. They need that back-up in a rural area. If you were in Dunedin you will have that back-up immediately."
Health New Zealand rural health co-director Rachel Pearce said the move was to improve access to care outside of normal business hours.
"An on-call clinician is available outside of those hours, including overnight.
"We encourage multiple providers to work together to ensure 24-hour coverage."
Clinicians are on call from 6pm, and on weekends from 9am to 5pm. On-site clinicians are available 9am to noon and 3pm to 6pm.
Heath Minister Simeon Brown said this was part of the nationwide $164million investment to strengthen urgent and after-hours healthcare services.
There was no solid answer as to what type of health professional would be attending the after-hours in person, or phone services.
"Depending on need, and may include general practitioners or rural hospital doctors, emergency medical technicians, allied health professionals, nurse practitioners, clinical nurse specialists, registered nurses, enrolled nurses, health care assistants or administrators," the statement said.
It was up to the healthcare provider to make that decision, and there was no mention of funding new staff.
Dr Fouke was also worried about the barriers patients would face when getting face to face with a doctor.
"Do you need to call St John’s, that adds stresses. Can you show up and be triaged like normal emergency care? It is not a true emergency room as it is not a full-care hospital as there is no specialist backup or ICU and all that."
The service will be connected to local Hato Hone St John, clinicians at Dunstan Hospital and Lakes District Hospital and with the emergency department at Dunedin Hospital.
Having worked across several international health systems, he said New Zealand was strained and Wanaka rated no better than others.
"In many ways the Cook Islands are much happier with their medical services than we are with ours here.
"They had a very finely tuned system where the GPs could pick up the phone to call specialists in New Zealand or Australia."
Advocate group Health Action Wānaka was pleased Health New Zealand had been listening.
"It’s great to see that there is progress on delivering continued after-hours care for our community," steering committee chairwoman Monique Mayze said.
The proposed service would remain free to all eligible children aged under 14.
Health Action Wānaka had advocated to Mr Brown and the ministry to remove cost as a barrier to people’s health in the Upper Clutha area.
"Our position is that symptoms that would be treated for free at a publicly funded emergency department, should be free for people in our community who present with the same symptoms seeking after-hours urgent and unplanned care.
"Given our isolation, including our distance from an ED and a tertiary-level hospital, people must be able to get the help they need, when they need it," she said.
Wanaka and its surrounds is facing some of the fastest growth in New Zealand.
The main town centre is 272km from Dunedin Hospital, 246km from Southland Hospital, 77km from Dunstan Hospital and 64km from Lakes District Hospital.
The framework describes four urgent and after-hours care service types, based on population, geographic and community characteristics. Wānaka is categorised as a rural centre.
