Covid-19 has people used to the idea of doing things remotely and now Whanganui District Health Board chief executive Russell Simpson says it could enable rural people to access healthcare without coming into town.
"It's been quite an enabler for many in our rural area," he told the Whanganui Rural Community Board this week.
"You shouldn't have to come into a hospital to get a service."
On the Whanganui River a house at Ranana is to be fitted with digital technology, and become a place where people can connect with health services.
Kaiwhaiki now has a defibrillator, and one is planned for Upokongaro. There are mobile dental and surgical caravans.
The board supplied a range of health services in Raetihi and Marton, Simpson said, while its Taihape facility is "more a general practice".
Whanganui District Health Board is responsible for meeting the health needs of 69,000 people across three districts. It has an annual budget of about $300 million, Simpson said.
That breaks down to $3800 a year per person - a higher level than that in other regions because Whanganui ranks high in the Health Ministry's socioeconomic deprivation index.
The per person spend sounded big, Simpson said, but one hip operation could cost $12,000 to $25,000 - "$3800 is used up pretty quickly, based on high needs".
Whanganui's population is growing - but mainly at the older end of the spectrum.
"We are not seeing a lot of younger families with less health needs moving back to Whanganui."
Asked about finance, Simpson said the board overspent its budget by $12.86 million last year, and this year its deficit would be $3.25 million.
He's confident he can "deliver against that" and said health provision was a delicate balance between over- and under-delivering.
"I don't want to make decisions based on finances. The budget is the budget. People still require services," he said.
Whanganui district councillor Brent Crossan asked about cancer treatment services in Whanganui. The Government had given $800,00 to enable chemotherapy to be delivered here, Simpson said.
"It won't be enough, but we will make it work because it's the right thing to do."
Radiation therapy is unlikely to be delivered here, because it needs a specialist team.
Asked about dialysis for people with kidney problems, Simpson said those who needed renal specialists had to go to Palmerston North, but 28 people in the district do home dialysis.
Rural dog control
The board went on to hear about rural crime and dog control. Whanganui rural liaison police officer Keith Butters said 70 sheep were stolen recently, in one go, and 200 trailers have been stolen from across the large Central Police District.
There had been a notable increase in stock worrying and wandering dog incidents in the rural area, Whanganui District Council compliance operations manager Warrick Zander said.
It would help if rural dogs were microchipped, because when they were trapped there was no way of knowing who owns them.
The wandering dogs were unlikely to be any of the 1525 working dogs in the district, board member Sandra Falkner said.
"Most working dogs are quite valuable and they don't usually let them wander."
The board heard from Whanganui & Partners agribusiness strategic lead Colleen Sheldon about results of its rural survey, then went into a workshop with council officers about proposals to review the council's dog control bylaw.
It meets every four to six weeks, chairman Grant Skilton said, and aims to be present at rural events.
"We are making an effort to be more engaged with our community."