Two years ago, people in the Central Plateau were fighting to save their rescue helicopter. Today, the service that was set to be scrapped is so busy that last year it flew nearly double the number of hours forecast. Taupō & Tūrangi Weekender editor LAURILEE McMICHAEL takes a look at the revamped Greenlea Rescue Helicopter.
Duty pilot Pete Masters is taking a break, catching up with some paperwork at the desk he shares with fellow rescue helicopter pilots Nat Every and Bernie McQueen in the Greenlea Rescue Helicopter base at Taupō Airport.
It's an increasingly rare quiet moment on a base that's much, much busier than was ever anticipated. It's 10.45am and the helicopter crew has already been out on one job today, a head-on crash near Taupō where two people were flown to Waikato Hospital. Nat, who flew the mission, has gone off shift and Pete has taken over, but crewman David Bayfield and intensive care paramedic Tony More are still at base.
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This morning's callout comes after a frantic day the day before when the helicopter crew - which comprises a pilot, a crewman and an intensive care paramedic - were called out four times in 24 hours. The sight of the rescue helicopter heading in or out of Taupō Airport is increasingly common and there are enough staff to make up three rotating crews, each comprising a pilot (Nat, Pete and Bernie), a crewman (Mark Bond, Libbie Faith and David Bayfield) and an intensive care paramedic (More, Rob Keating and Nigel Bryant).
So it's difficult to fathom that only two years ago, when a review of rescue helicopter services was under way, the Taupō rescue helicopter base was not included in a request for proposal issued by the National Ambulance Sector Office (NASO), a unit funded by district health boards, ACC and the Ministry of Health, which operates ambulance services nationwide.
At the time, the way rescue helicopters were organised was that most were run by charitable trusts in their area. Some owned aircraft and employed staff while others contracted local businesses. In the Central North Island, the Philips Search and Rescue Trust operated five rescue helicopters: Hamilton, Tauranga, Taupō, Rotorua and Palmerston North. The Government provided around 40 per cent of the money, with communities putting in the rest.
David Wickham of Philips Search and Rescue Trust says the trust had a single-engine Squirrel helicopter in Taupō and one fulltime and a part-time pilot. The crewmen were volunteers and St John provided paramedics for missions that required them.
"The service back in the day [pre-March 2019] was more fragile but it worked," Wickham says. "And really, it was the personal commitment of these guys, volunteers included, that made it work."
While the Taupō rescue helicopter was small and nimble, it was not as efficient as it could be. Precious time would be spent before missions finding a crewman and a paramedic. The arrangement with St John meant that up to 10 local St John paramedics had to be trained to work in the helicopter, and if the on-duty paramedics were on a job, the helicopter had to wait for one to become available.
Wickham says the Government had signalled for a long time that it wanted to move to twin-engine rescue helicopters, which had more space for patient care, and were safer in the event of engine failure. The aim was to have consistency nationwide so that everybody got the same level of service, regardless of location.
But what nobody expected was that when NASO put out its request for proposal - asking interested parties to submit a proposal for providing rescue helicopter services - that a number of existing bases would be left out. Essentially, NASO asked would-be operators to provide rescue helicopters at Whangarei, Auckland, Hamilton, Tauranga, New Plymouth, Hawke's Bay, Palmerston North, Wellington and in the South Island. Gisborne was left out, but quickly added back in. However, there was no mention of Whitianga, Rotorua or Taupō.
The exclusion of Taupō was a particular surprise given the number of missions the Greenlea rescue helicopter was flying annually, which was rising year-on-year, and also given that a significant proportion of its flight hours were spent on search and rescue assignments for the NZ Rescue Co-ordination Centre and NZ Police.
"The original request for proposal specified for the first time in enormous detail exactly what NASO wanted and thus we had to do," Wickham says. "It said 'we want an aircraft like this, a crew like this, a medical crew like this', and they wanted all twin engines, all dual-stretcher capable and a crew of four: two medical, one pilot and one aviation crewman.
"They put out the request for proposal and split New Zealand up into three territories: above the Bombays, the rest of the North Island and the South Island.
"To bid, you had to bid a complying tender - in other words, you had to give them exactly what they were looking for - and a complying bid was a full suite of those twin engines, a full crew and also in the locations they were looking for, which was no Rotorua and no Taupō."
When the news broke, communities with rescue helicopter bases that had been left out were outraged, and none more so than Taupō, two hours by road from the nearest tertiary hospital and surrounded by wilderness areas where people regularly hunt, tramp, fish and ski.
Part of the problem with the NASO request for proposal, Wickham says, was that it had been informed by a group of Australian advisers, who had vast rescue helicopter experience but came from a place where the terrain is largely flat. The Central North Island, ringed by mountain ranges, presents its own challenges for helicopter flying which hadn't been fully taken into account.
The mayors of Taupō and Ruapehu lobbied hard to central government, Tūwharetoa Māori Trust Board got involved, petitions were organised, a march was held and campaigns ramped up.
But behind the scenes the rescue helicopter trusts were quietly considering NASO's request for proposal. The five trusts which operated bases in the North Island below the Bombays organised themselves into a equally-owned consortium, Central Air Ambulance Rescue Ltd (CAARL).
CAARL put in a complying bid, which did not include Rotorua and Taupō, to provide rescue helicopter services in the central and lower North Island in line with NASO's request for proposal.
But the Philips Trust also managed to convince the CAARL consortium to put two non-complying bids to NASO, one which included rescue helicopter bases in Rotorua and Taupō, and another which included only Taupō.
And it was the second non-complying bid that NASO, after evaluating the information, accepted. Taupō was in. Rotorua, however, was still out.
"Where NASO changed their mind and included Taupō I'd like to think that we were able to display to NASO that if they wanted to achieve their objectives in a responsible way they had to include Taupō," Wickham says.
After some negotiation, NASO agreed to include the Taupō rescue helicopter on a four-year contract and in March 2019 the base received a new twin-engine BK117 rescue helicopter, painted in its Greenlea Premier Meats livery.
At the same time CAARL employed additional fulltime pilots, fulltime crewmen and its own dedicated intensive care paramedics. Wickham says the combination of the equipment and crews has improved and strengthened the services' effectiveness.
CAARL, through its subsidiary company Search & Rescue Services Ltd, now has eight rescue helicopter bases (Taupō, Hamilton, Tauranga, Gisborne, Hawke's Bay, Taranaki, Palmerston North and Wellington), 10 helicopters, 35 pilots, 37 crewmen and 37 paramedics; and supplies rescue helicopter services to the North Island below the Bombays. There is a back-office operation taking care of the paperwork, a maintenance scheduler who keeps the helicopters flying and a medical director who overseas patient care.
The five trusts which jointly own CAARL are still responsible for their own fundraising, although the Government contribution is slightly higher than in the past, about 75 per cent of operating expenses.
Under the new structure in Taupō there are now three fulltime pilots, 2.5 aviation crewmen and 2.5 intensive care paramedics, all solely dedicated to the Taupō service.
The big question is did NASO make the right call keeping a rescue helicopter base at Taupō? The figures speak for themselves.
The people who make the decision on whether to use a rescue helicopter instead of a road ambulance are those at the 111 Air Desk. They use ANTS criteria - weighing up access, number of people required, time and skills needed. It is totally independent from the rescue helicopter bases.
Philips Search and Rescue Trust's research, based on its experience, was that a new Taupō rescue helicopter base would fly 297 hours per annum. NASO's estimate was 235 flight hours. In the last 12 months to January 2020 the Taupō rescue helicopter flew 464 hours.
Wickham says not only did NASO get the flight hours estimate drastically wrong, so did Philips.
"If you compare the three months to January 2020 with the three months to January 2019, Taupō is up 98.6 per cent from last year to this year. Last year there were 79 [flight] hours in the three months to January 2019. And there were 156 hours for the three months to January 2020. So it's basically doubled."
Wickham attributes the increase in flight hours to several factors.
One is that new clinical pathways for rescue helicopters mean that seriously ill patients get flown straight to the place that can effectively treat them, rather than the nearest hospital. In the past, a patient would often be taken to Taupō Hospital and a retrieval team from a tertiary hospital, such as Waikato, sent down to get them. Now, for example, a badly burned person would get flown straight to the burns unit at Middlemore, a sick child would be delivered to Starship in Auckland and a patient having a stroke or a heart attack will go direct to Waikato.
Getting to the right care within four hours is proven to lead to better patient outcomes "which is really what it's all about", Wickham says.
Another is that rescue helicopters can now be dispatched more quickly. Pilot Every says in the past, by the time a crewman and a paramedic had been organised, it might have been faster to retrieve the patient by road. But now there is a complete helicopter crew ready to go at all times.
"Because our team are all paid and directly employed we're dispatching quicker than we used to which makes callouts quicker, which makes the helicopter a more attractive option because the sole reason for all of us being, is it's all about patient outcomes."
The Central Plateau is surrounded by wilderness so it's not surprising that Taupō, unlike other bases, has a reasonable proportion of search and rescue callouts. In the year ended January 31, the helicopter flew 43 hours on New Zealand Rescue Co-ordination Centre jobs, compared with Palmerston North's 35 hours and Tauranga's 11.
Taupō is now the second-busiest base (after Hamilton) south of the Bombays in terms of total work, Wickham says. While Hawke's Bay, Wellington and Hamilton's rescue helicopter callouts have remained relatively static, numbers have also jumped in the other provinces.
Taupō's BK-117 helicopter has a state-of-the-art avionics system, a longer, stronger winch and can fit a crew of three plus a patient and a family member. The pilot flies, the crewman operates the winch and assists the pilot and paramedic as needed, and the paramedic provides the medical care.
"Capability-wise it's a big improvement," pilot Masters says.
"And for us flying, it's way more stable, it's a better platform for night flying for us and we're doing so much at night."
Paramedic More says the bigger helicopter is far better for the patient because there is more room for the paramedic to work, and the patient and all the equipment are at a better height.
"We can have lights on now in the back. These guys can fly up the front with their night-vision goggles and I can have lights on and see what I'm doing."
Both agree that the new service and clinical pathways mean the Taupō district is getting a better service.
"We're doing more transfers to Rotorua so the Taupō community's getting to where they need to be faster, especially with stroke protocols - we're able to get these people to hospital in under four hours," says Masters.
Under the new rescue helicopter funding arrangement some 25 per cent on average of the rescue helicopter's money comes from its sponsors and the community, with fundraising as important as ever.
Wickham says the trust is grateful to the community and the helicopter's main sponsor, Greenlea Premier Meats, whose support never wavered.
Tony Egan, managing director of Greenlea Premier Meats, says the company stood by the rescue helicopter and continues to do so because the work it does is essential to the Central North Island.
"It would be absolutely unacceptable to have long delays when speed of response makes such a difference to many people," Egan says. "It was an easy decision to us because it was part of our company values of giving back to the community and we're proud to have our colours flying to the rescue every day...they [Philips Search and Rescue Trust] do a great job and it's a testament to their tenacity that they endured the tender process and never lost faith."
Greenlea Premier Meats also came to the rescue last month when all four of the Central North Island region rescue helicopters urgently needed $15,000 for flight barrier curtains to separate crews from patients, due to Covid-19 concerns. Public fundraising brought in $2000 and Greenlea stepped up with the remaining $13,000 to outfit the Taupō, Waikato, Tauranga and Palmerston North helicopters with the curtains.
Wickham says the rescue helicopter service Taupō has now is as good as anywhere in the country although its emphasis has changed slightly.
"In the past the job was to make a helicopter available to the St John paramedics, whereas nowadays we are the whole kit and caboodle. We've moved from being an aviation company to an aero medical provider.
"We've got a service, it's working perfectly. The Government got it right. This is the story of these communities that have come together throughout the Central North Island and they have produced something that's collectively doing 30 per cent more work than what it expected to.
"If you take the total work including police work, this base is the second-busiest base south of the Bombay Hills - and it's the base nobody wanted."
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