By Nick Truebridge of RNZ
A waitlist of nearly two months is blocking patients struggling with substance abuse from getting a bed at Auckland metro's main public inpatient detox unit.
Checkpoint understands those who fall ill waiting for a bed at Pitman House are instead advised to go to already overloaded emergency departments (EDs). The Waitematā District Health Board, however, contends EDs provide an adequate short-term solution.
Meanwhile, it has emerged some staff are concerned about the medical detox unit's move into Auckland's CBD.
Whaea Michelle Kidd has walked the halls and entered the cells at the Auckland District Court for decades. She supports the vulnerable, addicted and homeless as they navigate the justice system.
The country's biggest city is severely lacking in inpatient medical detox services, she told Checkpoint.
"To have a seven-week wait for anybody suffering from an illness is what I call sinful," she said.
Pt Chevalier's Pitman House can offer up to 11 beds in its medically managed inpatient withdrawal unit.
Kidd said anyone in desperate need of a bed should be able to get one.
"It's absolutely terrifying to feel like you're an outcast of our society and then, on top of that, to be refused or told, 'oh, no, I'm sorry you're going to have to wait another seven weeks because we actually don't have the beds'."
Checkpoint has been told people who became acutely ill while on the waitlist were being advised to go to an emergency department instead.
This week, it was revealed one of Waitematā DHB's own doctors had written to the Government saying the city's emergency rooms were "overwhelmed" by people presenting with alcohol and other drug-related harm.
People in need of inpatient care should not be directed to hospitals that did not have facilities for somebody to detox safely, Kidd said.
"That's wrong - and don't tell me there are other facilities for detoxification other than a police cell," she said.
"There are none. If you find one, please give me a ring."
Lieutenant-Colonel Lynette Hutson oversees social services at the Salvation Army.
The gap in time between getting someone a detox bed simply heaps more pressure on emergency rooms, she said.
"And surely the better thing would be to get more resource going into the detox to catch people when they're motivated to change and when they need that level of support," she said.
DHB defends use of emergency departments
A spokesman for Waitematā DHB, which operates Community Alcohol and Drug Services for Auckland metro, said there were some provisions for emergency admissions to Pitman House.
Despite the seven-week waitlist, just 7 per cent of patients required the level of care offered at Pitman House, he added.
The DHB believed emergency departments were the right place for those who fell ill while in the queue for Pitman House.
"Presenting to a hospital emergency department is an appropriate initial option for people whose medical needs may emerge abruptly but it is by no means the only service available to support people with severe substance-use disorder," the spokesman said.
The DHB dismissed the focus on Pitman House as misleading, saying it did not acknowledge the range of services available for those who did not require inpatient treatment.
"The opportunity also exists for patients who are very sick to be treated through the city's main hospitals when required."
Concerns over detox unit's move
But there's more trouble at Pitman House.
Checkpoint understands some staff are concerned about imminent plans to move the inpatient medical detox unit.
Kidd agreed, believing it presented further problems for unwell members of the public seeking inpatient detox services.
"Centralising these things is wrong, particularly in a place like Auckland central," she said.
"Frankly, we have enough of our problems here and our people would be better served if they were out of the city - in some sort of fresh air without tarseal, [in] proper, caring houses outside of Hobson St."
The DHB spokesman said management and the board made the decision to move the unit to central Auckland.
"The move to Mission HomeGround allows the CADS medically managed withdrawal inpatient service to integrate with complementary social detoxification services operated by Auckland City Mission," he said.
"This will result in an increase in access to managed withdrawal through the combined use of both services. It is inaccurate to suggest the relocation will result in a reduced service to patients."
Despite being able to run 11 beds at Pitman House, the DHB was funded to provide only 10 beds. That number would remain available at Auckland City Mission.
Staff had toured the new central Auckland location and, according to the DHB spokesman, gave favourable feedback and were looking forward to working at the City Mission.