West Coast Health proposes to close weekend, after-hours GP clinics, leaked documents show

Leaked documents show West Coast Health has recommended closing its weekly GP clinics and using a mobile service.

The submission – marked confidential and for Te Whatu Ora staff only – says the high workload and employment issues in the area have put pressure on primary care practices and their staff.

“Increasing patient demand, unmet demand from secondary care, an aging population, and an increase in chronic conditions are some of the pressures facing primary care workers,” reads the document.

“The expectation that nurses will work all day and be on call on weekends and after hours or walk on weekends or after hours is no longer sustainable.”

It noted that the GP workforce was also ageing, and that Te Whatu Ora estimated that New Zealand would have 1000 GPs as soon as 2033.

In the document, West Coast Health said another model is needed.

It encouraged all West Coast practices to adopt the telephone service provided by Ka Ora Telecare National Rural Telehealth Service as the leading after-hours and urgent care provider.

Patients will be instructed to call Ka Ora or go online when they call or visit their doctor after hours, where they will be screened by an operator.

Any consultation with a nurse may be free, but patients 14 and older may be charged up to $50.

Anyone who needs personal care will be referred to the nearest emergency department or an experienced rural nurse.

West Coast Health said the teleservice will increase operational efficiency and improve access by replacing short weekend clinics with 24/7 weekend care, among week and public holidays.

Voice Aotearoa Patient Chair Malcolm Mulholland described the proposal as a recipe for disaster.

“The closure of urgent primary care and after-hours health services in the West Bank will have devastating consequences for the people of the West Bank. The remote area has people older adults with high health needs who have limited access to cell phones and the internet.”

Mulholland was worried people needing emergency care would struggle to get it in a timely manner, and those with limited phone access and intermittent internet would struggle to use telephone services when they need them most urgently.

“I am not criticizing the stressed health workers of the West Coast. They are clearly overworked and underpaid in a health system that has failed to appreciate the problems they face. “

Mulholland says that although telehealth has its place in health, he does not see it working as it should in this case.

“It is not a silver bullet recommended by West Coast Health and is only one tool that can be used in certain situations.”

He said other options could include keeping some clinics open after hours in outlying communities, or having two more emergency care helicopters based in Westport and Fox Glacier to transport patients.

‘No decisions have been made’

Te Whatu Ora spokesman Philip Wheble, the group’s West Coast operations director, said the region was “very unique when it comes to the provision of health services, particularly primary care”.

“There are only three private general practices on the West Coast – one in Greymouth, one in Hokitika and one in Westport – with the remainder of primary care services provided by Health NZ. Although however the funding model remains the same as the rest of the country, with the local primary health organization West Coast Health sponsoring primary care, including after-hours services.

He said Ka Ora was “now available”, and the impact of using it after hours instead of GP practices was being discussed.

“No decisions have been made yet,” Wheble said, insisting that any changes would not affect emergency services.

“For clarification, the PRIME (Primary Response in Medical Emergencies) service is part of Hato Hone St John’s 111 emergency response. PRIME responders call and support Hato Hone St John to respond to emergency situations are available to do so. . This is not proposed to be changed as this proposal is about after-hours care, not emergency care.”