New Zealand / Covid 19

Relatives struggle with life expectancy requirement for urgent MIQ places

08:55 am on 23 December 2020

New Zealanders needing fast entry into the country to be with dying relatives are being tripped up by demands for proof of life expectancy.

Some hospitals say assessing life expectancy of patients is impossible and won't provide these. Photo: 123rf.com

MBIE wants the supporting evidence in applications for an emergency allocation to skip the queue for managed isolation.

But in some cases hospitals won't provide life expectancy information, arguing it is too difficult to say.

When Kimberley Dreyer's father was placed in the high dependency unit in Waikato Hospital on life support late last month, she scrambled to get from Queensland to be with him.

Under emergency allocation criteria brought in the following week, she could apply to skip the 10-week queue for managed isolation spaces and begin the process within seven days.

The application proved more difficult than she expected, when the Ministry of Business, Innovation and Employment requested a letter from a medical practitioner stipulating his life expectancy.

"My response to them was 'well, he's on life support and we've been told immediate family have been contacted to attend - so I'm guessing it's any day now.'

"But they wanted that in writing. I explained that I'd spoken to the hospital - which I don't think anyone should have to - to ask what my father's life expectancy was... and they'd told me they wouldn't be able to provide that," she said.

"The doctors that I spoke to and some of the directors at the hospital were quite astounded by the fact MIQ were asking for specifics."

Doctors told her all they could provide was evidence he was on life support, in a critical condition.

Dreyer began searching for cancelled managed isolation bookings herself, and just one day later, her father died.

Palliative specialist and clinical advisor for Hospice New Zealand, Rod McLeod, hoped the ministry wasn't being provided specific details on life expectancy because they're "nearly always wrong."

He admitted it would be difficult for the ministry to find any other way to gauge the urgency of applications, but said many people live far longer than expected, or they die sooner.

"I think it's at best a guess. The science around life expectancy is not very accurate. I think a lot of people would wish that it was but estimating life expectancy has so many variables and the ultimate variable is the individual themselves, who may want to hang on or let go," he said.

"Particularly at this time of year people often want to hold on for special events or special friends or relatives."

While the ministry won't stipulate exactly what it means by life expectancy, he said at best, medical practitioners might be able to estimate whether someone has either 'days', 'weeks', or 'months'.

Samantha Gallagher also ran into difficulties obtaining the life expectancy of her father-in-law, who was in palliative care with stage four lung cancer earlier this month while she was trying to return from Victoria.

"Everyone was like, 'Oh, we can't put a time limit on him. We can't put a time limit on a life. He's stage four, he could pass away tomorrow, he could have two weeks, he could have three'," she said.

It's the latest in a slew of complaints about emergency allocation since the criteria was widened three weeks ago to include people with dying relatives, people who need to care for children in unsafe situations, some critical workers and people stuck in travel limbo.

Yesterday MBIE admitted some applications were taking more than the target three business days to process, and that could be held up further if people didn't provide supporting details like the life expectancy of their dying relatives.

Davina Stonex, who went through the process to be with her dying mother, was accepted with a letter that stipulating she had "days to weeks" left.

But she felt there was "a lot of room for improvement" in the way the ministry communicated with applicants about the information it required.

"When I felt like the facts were being overlooked, then I just started coming to the point where I had to become emotional. I had to express the pain I was feeling and I have a dying mother I might not be able to see," she said.

"As appreciative as I am of the fact I could be here, early, it's only because I pushed and pushed and pushed."

In a statement, the ministry said it was sympathetic to the distressing situations of people applying for emergency allocation.

It said it was conscious people with terminal illnesses, like cancer, could have a significant range in their prognosis from weeks to months or years.

"In order to facilitate the most urgent visits while our facilities are full, we do need to ask this difficult question," a spokesperson said.

That includes assessing whether the applicants might be able to book through the Managed Isolation Allocation System to see their loved ones - which at this stage means waiting until March.

It said treating practitioners had generally been able to give advice on that point.