Health professionals in Te Tai Tokerau are calling for the Government to address a lack of resourcing and staffing in the region as part of the health reforms announced earlier this week.
"There aren't enough doctors, nurses, and kaiawhina workforce to meet the needs. It's hard to attract people. Part of the problem is there isn't enough funding," said New Zealand Rural General Practice Network CEO Dr Grant Davidson.
According to Errol Murray (Te Aupouri, Ngāti Kurī, Te Rarawa, Ngāti Kahu ki Whangaroa, Ngāi Takoto), who is the general manager of primary health and social service provider Whakawhiti Ora Pai in the Far North, part of the difficulty in attracting workers to the region stems from the isolation and pay disparity that currently exists between district health boards.
"Workforce has been problematic for us, especially when we have staff away ... It's distance and [gaining] pay parity, those are the main difficulties with attracting nurses," Murray said.
At times, the shortage of staff has forced Whakawhiti Ora Pai to close one of its three Far North clinics, meaning locals are prevented from accessing services or must seek alternative providers, often hundreds of kilometres away.
Adding to the issues in Northland is an ageing health workforce and an increasing general population. The average age of General Practitioners (GPs) in Whangārei is between 55 and 69, with a number of GPs retiring or about to retire. Currently, there is around one full-time GP per 1300 people across New Zealand. In Whangārei, there is one GP for every 1800 people, nearly 40 per cent more patients than the national average. Meanwhile, Northland's population grew by about 10,000 people between 2018 and 2020 and is set to keep increasing over coming years.
"Because of those dispersed populations, it costs more money to go out there and make sure we see all the people in the area," Davidson said.
Despite having some hope the reforms will be beneficial for rural communities, Davidson is disappointed at Health Minister Andrew Little's failure to mention rural populations during the reform announcements. He fears Little has overlooked the immediate needs of rural communities, which Davidson says are in "a crisis". He hopes the ministry will still address the need for more funding and staff in rural communities as the focus shifts to the transition into the new model.
"He [Little] didn't mention rural populations as a priority population to be looked at. The review of the Health and Disability system clearly indicated that there are inequities amongst rural people in terms of their health outcomes ... The current health system is failing rural populations. There's a crisis in rural health," Davidson said.
Besides staffing issues, Murray hopes the reforms will lead to shorter wait times for patients' access to specialists and operations, increased access to telehealth services, and better internet connectivity for rural clinics and patients. He is also hopeful providers such as Whakawhiti Ora Pai will be able to lower their costs for patients, removing another barrier to accessing healthcare services.
"It'll be interesting to see whether or not there will be an increase in capitation payments so we can lower our costs for our whānau," Murray said.
To solve some of the issues currently facing the region, Davidson says schemes need to be in place targeted at training and retaining staff in rural areas. He also called for improved connectivity and access to telehealth services.
"We'd like to see a targeted training scheme for rural doctors, nurses and kaiawhina where they target rural people and train them in those areas so they don't have to leave; rural funding adjustment for practices working in those areas; and a commitment to extending rural broadband services so people in remote areas can access telehealth systems," Davidson said.
Meanwhile, other health experts are hoping the reforms will lead to better access to health services for members of Northland's disabled community. One expert is calling for a separate disability health authority to be established, much like the newly announced Māori Health Authority.
"It would be really good to have a disability health authority, much like the new Māori Health Authority, that's what the disabled community would like to see ... It's an opportunity to really address inequalities in health for disabled people. It depends on how the new health authority, Health NZ, is going to approach those inequities between disabled people and non-disabled people," said Tiaho Trust CEO Jonny Wilkinson.
According to Wilkinson, the diversity of health issues the disabled community is faced with and a lack of adequate advocacy means mistakes are often made when resources are allocated. He would like to see a nationwide adaptation of a model currently in place in Central North Island, where people with disabilities are in charge of budget allocations.