More ambulances are needed in Central Otago
Inadequate ambulance services in Central Otago could lead to "clinical disaster'' unless more are provided, say the region's GPs, who have taken their concerns to a national level.
The concerns were outlined in a letter sent last week by Dr Christine Williamson, chairwoman of the after-hours medical service in Central Otago, Central Otago After Hours Inc (COAH), to St John Prime (Primary Response in Medical Emergencies) national administrator Denise Guy and Otago-Southland district operations manager Pauline Buchanan.
The letter has also been copied to 11 other national, regional and local St John, government and health representatives, and all the GPs in Central Otago, not all of whom are part of COAH.
GPs from the Cromwell Medical Centre are not part of COAH, and were against its formation. They declined to comment on the letter.
Dr Williamson said about 10 GPs provided after-hours care through COAH. They were mainly concerned about the Cromwell region, but also Alexandra.
She said Cromwell often had no ambulance crew on duty from 7pm to 7am, and the entire Cromwell-Alexandra region was sometimes covered only by a single ambulance crew in Alexandra during that time.
This was placing Cromwell patients and Alexandra patients at risk, if the single Alexandra crew was on a callout to Cromwell.
She has asked St John to make the issue its "highest priority'' and said it needed ``urgent attention to prevent clinical disaster''.
She said no dangerous clinical incidents had yet occurred because of the shortage of ambulance crews, but it was ``a question of time for that to happen'' and there was "increasing risk all the time''.
At various times, the shortage of ambulance cover had meant GPs had had to travel to Cromwell to see patients during the night rather than the patients being transported to the after-hours centre; police cars had had to transport patients to the centre; and there had been a shortage of ambulances to transfer patients to Dunedin.
Dr Williamson said the peak summer holiday period from December 19 to January 29 was a particular concern and extra St John staff should have been brought in to help last summer. The GPs wanted the issue resolved before next summer.
St John had to recognise the "special character'' of rural ambulance requirements, where the average total callout time was much longer than for urban crews, Dr Williamson said.
The Otago Daily Times asked St John a series of questions, including how many paid and volunteer officers were in Central Otago, if there was a shortage of volunteers, what was the typical response time for rural ambulance crews in the Cromwell district and if any clinical situations had arisen from a shortage of ambulance crews in the region.
Mrs Buchanan replied with a statement that said:
"St John is aware of the population pressures on medical services generally in Central Otago, Cromwell in particular. Newly appointed Central Otago territory and Cromwell station managers are committed to the region and are focused on working alongside other healthcare providers to ensure their respective communities are adequately resourced.
Government funding for ambulance services throughout the country has been under review for some time and St John anticipates the outcome of that review will greatly assist planning for how services can be delivered to the region's changing population in the future.''
Dr Williamson said the concerns about ambulance provision were part of broader concerns.
"By default, we [COAH] find ourselves providing the emergency services for all the people who holiday and work seasonally in Alexandra and Cromwell because there is no Accident and Emergency Services at Dunstan Hospital.
This is a matter that the Southern District Health Board must be cognisant of but no funding follows all these visitors to this area ... There are chains of responsibility which relate to inadequacy of funding for the health of rural people as well as the failure of funding to follow the huge population migration that occurs within the SDHB to the Central Lakes area during the holiday period''.
The SDHB did not provide a response to questions by deadline.
pam.jones@odt.co.nz