'If they can't do it we will': Iwi vows to keep Porirua’s overnight health service

Monday, 22 April 2024

Ngāti Toa chief executive Helmut Modlik says not providing an overnight health service for patients in Porirua is not acceptable.

Ngāti Toa’s leader says he will not allow health authorities to replace Porirua’s overnight medical service with a telehealth service, saying if Health New Zealand can’t find doctors, his iwi will.

Health New Zealand — Te Whatu Ora is yet to make a decision on replacing the 10pm to 8am overnight service at Kenepuru’s Accident and Medical Centre with a virtual health service due to doctor shortages.

Ngāti Toa’s chief executive Helmut Modlik said anything less than an in-person overnight service was unacceptable.

“If they won’t action on their own volition what's needed, we will,” he said.

“Porirua has some of the highest concentration of deprivation and need anywhere. The idea you would unwind in any degree, the availability of care is scarcely credible.”

The overnight service has been staffed by temporary senior doctors, who come at a high cost, since at least September last year.

The shape of Kenepuru Accident & Medical Centre’s overnight service has been in question since last year.

Despite mounting pressure from community leaders and the senior doctors union, neither the health agency nor the health minister will commit to a timeline for a resolution.

It comes as senior urgent care physician outlines the value of the service.

“If the service is closed overnight I expect patients will chose to wait out time-sensitive conditions at home,” said Dr Tom Sanders, speaking as a member of the Association of Salaried Medical Specialists (ASMS).

He said subtle signs of illness were best assessed in person.

Sanders did overnight shifts at Kenepuru’s Accident and Medical Centre for 15 years, until mid-2022 when it became “too demanding”.

“It's not uncommon now for the overnight doctor to see sort of upwards of 20 patients in one shift.”

Typically, one or two of those patients would be considered ‘high-acuity’ — experiencing a severe problem that means they need urgent help, he said.

MP for Mana Barbara Edmonds is ready to picket to save Kenepuru’s overnight health service.

Then there were patients who might not appear serious, such as the patient who appeared one night with what she thought was a toothache. “Turned out she was having a heart attack,” Sanders said.

Mana MP Barbara Edmonds is ready to picket to save the service, as are hundreds of others she has spoken to in the community.

“It feels like no one is listening … and no one is talking to us.

“They’re also saying ‘we'll make a decision and then we'll let the community know’. This is the wrong place for that sort of approach … engage with us, talk through the difficulties and see how we can support you.”

Health NZ’s hospital and specialist services spokesperson for Capital, Coast and Hutt Valley, Jamie Duncan, said the agency had been working with Ngāti Toa and the ASMS on how to the community’s needs “with the resources we have”.

That still included a possible virtual service “while we look for a longer term solution”.

Telehealth was still under consideration “both locally and at a national level”, and no decision had been made, Duncan said.

Helmut Modlik says he expects health authorities to engage and support a solution that maintains an in-person overnight service.

Modlik expected health authorities to engage with Ngāti Toa and its primary health organisation arm, Ora Toa, about a solution that retained round-the-clock in-person health services.

“We expect them to co-operate with that, to support that, to fund that. Since they can't find people, we will.”

While the details would have to be worked through, Modlik said it would likely involve doctors from the iwi’s health organisation arm, Ora Toa, other local doctors and new recruits.

ASMS executive director Sarah Dalton accused Health NZ of refusing to properly invest in Kenepuru’s overnight service, calling it “systemic racism in action”.

“it’s treating that whole community as though they are rural and remote.”

Porirua city councillor and resident Tracy Johnson is worried about the Kenepuru after hours health service, which is at risk of closing down due to staff shortages.

Porirua city councillor Tracy Johnson described the overnight service as a vital resource.

Johnson has chronic kidney disease and says the after hours service brings a sense of security to many who have ongoing health conditions.

“You're not necessarily sick all the time. But when you are, accessible health care is just so important.

“I want to know that I can go somewhere and see somebody… it comforts me knowing I can go to a local place.”

Health Minister Dr Shane Reti would not say whether he expected Health NZ to maintain an in-person overnight service but remained confident the agency was committed to safe health care for people who use Kenepuru’s Accident and Medical Centre overnight.