Mahurangi health: A charity case

News that a new urgent health care clinic will open in Warkworth will be a relief to Mahurangi residents. But Jonathan Killick discovers the region’s health needs remain heavily dependent on charity. He spoke to fire brigades, St John, district health boards, hospitals and the Westpac Rescue Helicopter Trust to get a big picture look at local emergency services …

A common thread to emerge from discussions with emergency services is that long distances, population growth and the lack of a local hospital emergency department have left a gap that has so far only been filled by the generous contribution of volunteers and charitable organisations.

The area is served by four ambulances in four stations between Puhoi and Brynderwyn – at Warkworth, Wellsford, Mangawhai and Maungaturoto.

If an ambulance picks up a patient in critical condition from School Road in Wellsford, it has a choice to drive 80 kilometres to Whangarei Hospital or 70 kilometres to North Shore Hospital.

St John Rodney territory manager Megan Fairley says the demand for ambulance services in the area is growing significantly.

“While we will always be there for people when they need us, the growing demand coupled with funding constraints means patients with low acuity [less serious] illnesses and injuries may have to wait longer for an ambulance,” Megan says.

“It would benefit us and the community if there was a centrally located Accident & Emergency established in Warkworth or Wellsford,” she says.

Data provided by St John shows that the four stations received 4212 ‘111’ calls in the 12 months to mid-December last year and responded to 89 per cent of them.

The remainder were largely covered by volunteers from local fire brigades who are increasingly committing to medical training every six months to be qualified first responders.

The proportion of medical emergencies that fire brigades respond to is especially high in semi-rural areas with medicals representing 86 per cent of callouts in Matakana, 63 per cent in Mahurangi East, 66 per cent in Leigh and 42 per cent in Wellsford. This is excluding motor vehicle accidents.

Despite Wellsford having a 24-hour urgent care clinic and a mobile emergency doctor, fire station officer Tarah Jones says medical callouts in Wellsford have been on the rise due to the lack of an overnight ambulance.

She says the majority of medical alerts the Wellsford brigade attends are cardiac arrests.

“We have a good success rate if you get the call within 10 minutes of the person falling down. However, a couple of years ago we had three cardiacs in four weeks and they each died, which took its toll on the crews.”

Leigh firefighter Tony Enderby says wait times for an ambulance in Leigh were once half-an-hour, but are now typically an hour.

He has also received feedback that ambulances have had to wait at hospital for up to two hours before a patient can be seen.

Twenty years ago, the Leigh Volunteer Fire Brigade was the first in the area to get medical training in response to higher ambulance wait times, and today nearly all of their crew are first responders.

When a first responder from a brigade attends an emergency, they check the vitals of a patient and call a St John helpline to receive advice, and may be guided on administering medicine such as pain relief or adrenalin.

“I would say three or four times a year, someone would have died if we hadn’t been there in time. Bringing someone back is the most amazing thing you can do,” Tony says.

“We fill the gap as well as we are trained to do. We are doing it as amateurs and working our hearts out, but until the true professionals get there, we are just in the lap of the gods.”

Tony says this is where the Westpac Rescue Helicopter Trust provides an invaluable service in delivering critical patients to hospital.

Westpac Rescue Helicopters attended 112 incidents in the Rodney district, from January to November last year.

Geographical hotspots include 18 rescues in Wellsford, 11 in Warkworth, six in Omaha and five in Leigh.

In 2018, there were 123 rescue missions for the whole year in Rodney, compared to 100 rescues in Franklin and North Waikato. In 2017, the difference was even more pronounced with 141 in Rodney and 93 in Franklin-Waikato.

Last year, Leigh’s Douglas Calvert, 9, found out he was allergic to tree nuts when he ate a homemade bliss ball and his throat began to close up.

Mum Julia Casey said she was fearful to drive to the Wellsford Medical Centre, because if his condition worsened, they would be without cell phone coverage for up to half-an-hour.

She called 111 and the Leigh brigade arrived and administered an adrenalin EpiPen which improved his condition.

However, Julia was advised that if the reaction returned once the adrenalin wore off, the consequences could be fatal, so Douglas was transported to Starship Hospital by the Westpac Rescue Helicopter.

“Without the helicopter, it would have been a nightmare. My partner rounded the kids up and drove down to Auckland and it took an hour and a half.”

“The crew were so knowledgeable about the impact on the family, and they always let us know what was happening next and reassured us.”

In the 12 months to November last year, 4073 patients living north of Puhoi were admitted to the emergency department of North Shore Hospital, while 1941 patients south of Brynderwyn were admitted to Whangarei Hospital.

According to Statistics NZ, the population of the Rodney District has grown 23 per cent from 57,300 at the 2013 census to 70,400 residents in 2019. The Kaipara district grew 17 per cent from 20,500 to 24,100.

Waitemata District Health Board Rodney ward elected member Allison Roe says she personally allocates two hours to travel from Point Wells to Auckland for meetings where it used to take 45 minutes.

“I am conscious that many people are feeling that with fast growing populations, traffic gridlock and waiting times, health services in the north could be closer to home,” Allison says.

“The DHB is maintaining a close watch on changing demographic trends to ensure that we will have the right, sustainable options ready.”