Child neurology service 'at crisis point'

5.30pm - By JULIA MAHONY

Specialist services for children with epilepsy and other neurological disorders are at crisis level and could collapse, health workers say.

Two paediatric neurologists had quit New Zealand in the past two years, leaving the country with just two full time consultants -- in Auckland and Christchurch -- and one part-time consultant in Wellington, Paediatric Society president Nick Baker told NZPA today.

That was not enough and in areas such as Taranaki, Wanganui, Gisborne, Hawke's Bay and parts of the South Island, children with conditions were not being seen, he said.

"If they aren't an immediate emergency, they tend to join a long waiting list."

Dr Baker blamed the problem on not having a national paediatric neurology service.

The current service was being run in "21 fragments" within the 21 district health boards (DHBs).

The specialist area covers epilepsy, neuro-muscular disorders, some mental handicap problems and metabolic diseases.

Dr Baker said individual DHBs were not keen to fund the specialists, because a lot of their work was done outside that DHB area.

"The South Island desperately needs a second consultant, but why would Canterbury DHB recruit one when the board's job is to only serve the Canterbury population?"

Dr Baker said one young registrar in Canterbury was keen to train in the speciality, but could not get funding.

"To get a quality national service, we need a way of funding it, some networking system or glue to hold it together and something to secure sustainability," he said.

"We need a core of people working the big centres, so instead of having a whole family fly from Taranaki to Wellington for the day, you have one person fly to Taranaki.

"We don't have that now, and the service is at crisis point."

Dr Baker said a good model was the children's cancer service.

"Wherever a child gets cancer in New Zealand, there is a defined place to go for immediate care, then the local team in your home town is supported by the national service through things like teleconferencing, outreach clinics and every new case is discussed by a national tumour board."

There was a worldwide shortage of paediatric neurologists and New Zealand needed to do more to attract them.

"If someone put $3 million into it tomorrow, we could not recruit the people, but we'd have a much better chance if there was a national network to recruit them to."

Offering more attractive pay was unrealistic for New Zealand.

"We are not going to triple people's salaries. We have to appeal to people because they are coming for lifestyle, to work in a harmonious service."

Auckland had been trying to recruit a paediatric neurologist for 18 months, but the job was not attractive in its current form, Dr Baker said.

Training in paediatric neurology required a medical degree, three years training to be a paediatrician and three to four years advanced specialist training.

The country's only part-time specialist, in Wellington, wanted to work more, but the DHB would not fund her full time as her work would take her out of the district, Dr Baker said.

The Health Ministry today said it would discuss ways to relieve some pressure on the service.

Christchurch consultant, Paul Shillito, who covers the entire South Island said children were being seen depending on where they lived, no matter how serious the case was.

"I could see a child in Christchurch with a migraine who could easily be seen by a general paediatrician, and yet I just can't see a child somewhere else in the South Island ... who has intractable epilepsy," he told National Radio.

"The system is very badly organised."

DHB chief executives' group chairwoman Jan White said she would meet with the Paediatric Society next month to discuss specialist numbers.

About 5000 children in New Zealand have epilepsy and up to about 20 per cent of them have uncontrollable seizures.

The Health Ministry's child and youth health chief advisor Pat Tuohy today agreed there was a shortage of paediatric neurologists.

"We discussed possible, short-term solutions with DHB managers last year and raised the issue with DHB chief executives earlier this year," he said in a statement.

The ministry would meet with chief executives to discuss co-ordinating secondary and tertiary paediatric neurology services at a regional and national level, Dr Tuohy said.

Guidelines for the delivery of paediatric neurology services were in the final consultation process.

- NZPA