A Northland health trust is in crisis after the resignation of its chief executive, chairwoman and many of its clinical staff.
The health board, however, is assuring patients in the Whangaroa area that locums, or fill-in GPs, will be in place to make sure locals can still get the medical care they need.
Chief executive Mana Hape, who took the reins of the Kaeo-based Whangaroa Health Services Trust in 2015, resigned this week along with trust chairwoman Violet Walker.
While no official reason has been given for their departure and it comes after an exodus of health professionals. The Advocate has approached both for comment.
An emergency meeting of the remaining trust members was held in Kaeo on Monday night to decide the health trust's next steps. The trust operates a hospital and rest home at Kaeo and delivers free primary health care to more than 3000 people in the Whangaroa area.
Public concern about future provision of health care in the area, which has some of the country's highest health needs, has been mounting in recent months with the departure of key clinical staff, in particular long-serving doctor Alison McAlwee.
The only permanent GP still employed by the trust, Dr McAlwee finishes this month to take up a new position with Broadway Health, which has clinics in Kaikohe, Waipapa and Kaitaia.
Two more nurses are believed to have resigned last week.
Members of the public at a packed annual general meeting on May 29 quizzed trust management about Dr McAlwee's resignation and long waiting times to see a GP. It emerged that staff had written a 50-point letter of complaint alleging bullying and raising concerns about patient safety, overloading and a ''blame culture''.
Meanwhile, Northland District Health Board is assuring Whangaroa residents they will still be able to see a doctor and that Te Tai Tokerau PHO — the organisation that oversees primary healthcare in the Far North — had prepared a six-month roster of locums, or short-term GPs.
DHB planning manager John Wansbone said the priority of all parties was to maintain clinical services for the Whangaroa community. The PHO could call on a pool of seven locums who worked in a number of practices around the Far North.
The health board was aware of two resignations from the trust during the weekend and would be advised later this week of the outcome of Monday night's urgent meeting.
Meanwhile, Wansbone said auditing firm Ernst & Young was carrying out an independent review of the trust on behalf of the health board, the trust and the PHO.
The purpose of the review, which was due to be completed by early August, was to establish how primary care services could be delivered in an accessible way in the Whangaroa area.
He would not say if he had seen a copy of the staff complaint letter, but said the health board was ''aware of the significant challenges that Whangaroa Health Services Trust, its wider staff team and community are currently facing''.
The Ernst & Young review would include meeting frontline staff and iwi to help ensure the trust's health services were ''fit for purpose'' for all users, he said.
A Taupo Bay resident, who did not want to be named, said he was worried by the resignation of a number of GPs.
''There's only one left, and now she's resigned ... She'll be missed, she's brilliant. She's been here since the year dot.''
He was also worried the trust's mobile medical clinic, which used to call in regularly at Taupo Bay and other isolated spots, could be scrapped due to a lack of staff and funding.
''We're rather concerned. Health is an important thing. If I had to I would drive somewhere else and pay the difference but not everyone here can do that.''
It is not the first time the trust has faced controversy and heated public meetings. A previous chief executive, Garry Ware, resigned suddenly in 2013 with the role job-shared between a lawyer and a truck driver until Hape's appointment.
In recent years, the trust has also grappled with funding cuts while health needs continue to escalate.
Whangaroa and Hokianga are the only places in the country where primary heath care, such as GP visits, is free.