The Parkland Medical Centre Photo: RNZ / Emma Andrews
Another medical centre has fallen victim to the nationwide shortage of GPs, but a kaupapa Māori health service is invigorating another.
Not enough clinical staff can be found to keep North Taranaki's Parklands Medical Centre operating, and the clinic is being merged with another practice.
It is the region's second OmniHealth-owned casualty in four months, with 2500 patients affected.
OmniHealth chief executive Mark Wills said it was not sustainable to keep Parklands Medical open with just one nurse practitioner, who was about to go on a sabbatical leave.
"We needed to make a decision that's going to ensure the continuity and stability of the service for the patients, and so this is the call that we've had to make," he said
Since May, the practice had been running on Telehealth as a result of Covid-19 slowing the flow of international medical staff.
Māori health service saves medical centre from closure
The Parklands clinic was now being merged with the OmniHealth Strandon practice in New Plymouth, which had a GP and a nurse prescriber, and now the nurse practitioner from Parklands.
Former Parklands staff were able to apply for a job at the merged site, however only one person was willing to make the move.
The Parklands patients were also transferred to the Strandon health centre.
Staff, who wished to remain anonymous, said they were shocked by the closure announcement.
"They gave us notice on 12 August that we had to go back to them with a proposal on how we can keep this place open," one said.
"We done our proposals and still came out with redundancies."
On Friday 30 August, the team were contacted by OmniHealth to "bring a support person on Monday" - the date the team were handed their redundancy notices.
Wills told RNZ there weren't any viable solutions.
From Omni to Māori health
The Waitara Health Centre, located less than 10 km north of Parklands Medical, transitioned from OmniHealth to become part of Tui Ora, a kaupapa Māori Health organisation, on 1 June this year.
A former Parklands patient, who lives within walking distance of the Waitara clinic, now has to travel an extra 20-minutes to Strandon.
"Tui Ora has been wonderful at picking up Waitara and trying to serve it with doctors."
She would sign up with Waitara if she could, but their books are full.
Tui Ora Pou Whakahaere Tākutatanga (clinical director) Dr Bernard Leuthart said kaupapa Māori health organisations were a step up on primary health care that serves on a "15-minute wonder model".
He said the required government funding for general practice was not there.
"The model has failed us."
Tui Ora is working on a ratio of one doctor per 1500 patients while "patching up the full time equivalent (FTE)" with Telehealth.
They are also gaining two doctors next year, one being wāhine Māori.
"I guess we're an attractive prospect in terms of seeing primary care differently, which is appealing to GP's, and we've been able to pull some people in through on that kaupapa," Dr Leuthart said.
But they were still three doctors short of their ideal doctor-to-patient ratio that would serve about 9000 patients.
Working for Māori, by Māori
"It's challenging stuff everyday, it's trying to do stuff in ways that slices the limited cake to get the best outcome," Dr. Leuthart said.
"We're interested in putting pressure on amenable mortality statistics, we're interested in keeping people away from the hospital."
The disestablishment of Te Aka Whai Ora has added pressure on Kaupapa Māori Health organisations but it hasn't changed their delivery.
"While Te Aka Whai Ora was a brilliant affirmation of "by Māori, for Māori" we're still continuing our mahi."
"We provide a low-cost service for patients and keep our provision as good and as high as possible in the face of very high utilisation."
They also have kaiāwhina, kaihāpai, and kaitautoko roles that are a staple to their medical services. These people know the community they're working with and are employed to help make direct contact with whānau to ensure their needs are met, he said.