Communities rally against telehealth option for Kenepuru's clinic

Communities in Kāpiti and Porirua have rallied against telehealth being brought in as an option at Kenepuru Community Hospital.

Health New Zealand / Te Whatu Ora has contracted the service to provide after-hours care at Kenepuru's accident and medical clinic in case its accident and medical clinic cannot be staffed overnight.

The hospital services around 120,000 people in Porirua, Tawa, and the Kāpiti Coast.

Labour has been holding public meetings to hear from the communities Kenepuru covers.

While Health New Zealand has said telehealth has not had to be used yet at Kenepuru, members of the community at a meeting at Mungavin Hall in Porirua on Wednesday night said the only option for them was to keep the clinic open all hours.

"For us, that's not an option to replace it. We need it, we need the 24 hour service in this community," Aiga Caroline Mariko said.

"We've always been known for high health needs, and also we have a community that really relies on the after-hours because of the respiratory problems that our kids have."

GP Sarah Sciascia has worked at Kenepuru's A&M. She said she was not an ED specialist and GPs often feared working overnight because of what may come in the door.

She said telehealth could not replace a fully-staffed emergency department, especially for communities that valued kanohi ki te kanohi consultations.

"If English is your second language, if hearing is an issue, then using the phone doesn't work. And most of the time, when Māori or our Pasifika brothers and sisters need help medically, then we need to be seen, we need to be assessed. When telehealth is the only option, then the potential for things to go awry, for health to deteriorate, is huge," she said.

Staff shortages are causing problems right across the health system.

In the past few months, other community hospitals have had to bring in telehealth to cover the shortages.

Labour's health spokesperson, Dr Ayesha Verrall, said telehealth was not appropriate for certain emergencies and accidents, and its use instead of in-person healthcare was essentially a frontline cut.

"You cannot suture a limb, you cannot listen to a chest on telehealth. Those things need to be taken care of in-person. Telehealth has its place in our health system, but I fear it's being overused while services are being cut to communities," she told RNZ.

Verrall said when she was health minister she had made it clear to Health New Zealand that the after-hours service needed to remain open, and was disappointed at the level of analysis of options that Health New Zealand had undertaken.

"It seemed to me that there hadn't been any creative thinking about how to solve this problem. Just 30km down the road in Wellington, there's hundreds of doctors and nurses at work every night, and yet we can't provide one or two for Kenepuru? It seems absolutely ridiculous."

Communities could go to Wellington Regional Hospital or Hutt Hospital after-hours, but Labour's Mana MP Barbara Edmonds said for some that was simply not an option.

She said Kāpiti had the highest density of over-65 year olds in the country, while Porirua had one of the youngest populations and was one of the highest income-deprivation areas.

"The biggest barrier for them is transport. Particularly after-hours, public transport is not working at the same time. So for them, they depend on being able to access it quickly and locally," she said.

"So whether that's ringing somebody up in the middle of the night to say 'come and take me to Kenepuru after-hours,' or for parents, it's only twenty minutes away. When you've got a child who's struggling to breathe, that's a real struggle for them."

Edmonds said she appreciated the telehealth option was a 'just in case' but still viewed it as a cut to public services, and said Health New Zealand needed to find a sustainable option.

The meeting was also attended by Ngāti Toa chief executive Helmut Modlik, Porirua mayor Anita Baker, and Association of Salaried Medical Specialists executive director Sarah Dalton.

Dalton said the situation was at odds with the purpose of Health New Zealand: to bring together the DHBs into a single health system so everyone would get better and more equitable access to care.

"Telehealth is a cut. This proposal is the classic postcode lottery approach to care," she told the crowd of around 80 people.

"Senior doctors are critical to maintaining safe and timely healthcare in hospitals, communities, and urgent care settings. We know that respiratory illnesses, cancers, and other life-threatening conditions, issues facing newborns and young children and other serious health conditions do not respect a nine-to-five weekday timetable."

Baker told the community that Health Minister Dr Shane Reti had assured her that he would keep Kenepuru's after-hours clinic open.

"He has sworn to me and promise it will stay open. And I can be quite nasty if he changes his mind, because this is my community," she said.

"I have to have faith in minister Reti that he keeps it open, because I tell you, there'll be all hell that will break loose in this city if he doesn't."

Reti told RNZ that workforce shortages were always a challenge, and he had asked Health New Zealand multiple times to find the staff so telehealth services would not have to be used.

"It is always preferable to have person-to-person, face-to-face. That is not the situation we find ourselves in, and so it is a temporary measure until we can build that health workforce. So no, it is not ideal, but it does provide some mechanisms for after-hours care," he said.

In a statement, Health New Zealand's Capital, Coast & Hutt Valley group director of operations Jamie Duncan said Kenepuru remained open 24/7, with no gaps in the rosters.

"To date, we have not needed to utilise the telehealth service - however we have this as an option if unexpected roster gaps mean that we cannot have a doctor physically onsite overnight," he said.

"Across our services we continue to actively recruit, however we do so in the face of a global shortage of suitably-qualified health professionals. This challenge is not new, nor isolated to one service or district."

He said no decisions about Kenepuru had yet been made and Health New Zealand would continue to work closely with iwi and other partners, including unions, to consider all options.

Duncan was at the meeting, along with Health New Zealand chief executive Fepulea'i Margie Apa and Ikaroa regional deputy chief executive Robyn Shearer.

They told the community there was "no debate" around Kenepuru.

"Our whole direction is to try and get more into communities, so you don't have to drive all the way or worry about parking. And when we can get staffing to come and work out here they actually love working in this city. So, no debate about Kenepuru Hospital from a Health New Zealand perspective," Apa told attendees.

RNZ's request to interview the Health New Zealand representatives after the meeting was declined.