Health – Open all hours? Not!

Will the Hibiscus Coast ever have a 24-hour a day emergency medical facility? Sadly the answer is “no”. Every time the medical needs of this community are surveyed this question of after hours care comes up. It’s been the same for years now and unfortunately some hard realities need to be faced. We will never go back to the old system of a doctor being on call at night, though in some rural areas the dedicated GP’s maintain this service. The fact is that this level of commitment is incredibly demanding. While we all did it when we were younger, the capacity to do house calls during the night and then function properly the next day wanes as you mature. The need to balance work and personal welfare are important considerations for GPs at every stage of their careers. Consequently it is very difficult to attract doctors to areas where an on-call roster applies. While we might lament the passing of an era it is much better to think about other ways in which the medical needs of the community can be met.Therefore the emphasis of the Ministry of Health, the District Health Board and the Primary Health Organisations has been on:
• Good access to phone advice about health issues after hours
• Centralised emergency facilities within reasonable driving times
• Subsided services to certain groups

All GP practices now automatically direct after-hours calls to a triage nurse who can provide advice. In my time on call probably half or more of the night time calls could be resolved by phone advice, so this is a highly effective way of dealing with those enquiries. In addition, Healthline (0800 611 116) provides a 24-hour a day phone advice service for general medical problems. My patients find it tremendously reassuring to know that this expertise is always available.

The Auckland Regional After-Hours Network co-ordinates emergency centres throughout the region and supports the four A & M clinics, which are open 24 hours.  The low patient numbers seen at each clinic between 12 midnight and 7am (surprisingly only a dozen or so) means that this service is always loss-making and needs to be subsidised.

Extra funds have been made available to lower costs for after-hours visits to 24-hour clinics for certain vulnerable groups (under 13s, over 65s, community service card holders and people from low income areas). Not a perfect solution but a step in the right direction.