Hospital stays but some beds to go

Ruapehu Bulletin, Volume 6, Issue 295, 18 July 1989, Page 1

Hospital stays but some beds to go

"It is important that the changes to our health service are to be for the betterment of Waimarino people," was one of the closing comments, from Mathew Mareikura, at last Tuesday night's meeting on future health service changes.

"We do expect a better service with the changes and we certainly don't expect anything less than we've got now," he added. The meeting, at the Raetihi School Hall which was chaired by Mayor Garrick Workman, was arranged , to give Waimarino residents a chance to air their views on our health service and to ask questions about concerns over the Wanganui Area Health Board's plans to set up a Rural Health Centre in the Waimarino. Gathering information The Board representatives, Wanganui Area Health Board manager of community services Margot Mains and Board General Manager Rob England, said from their point of view the meeting was an information gathering exercise, to hear about the

particular areas of concern for Waimarino people and to listen to ideas. "We will come back later with the proposals we have worked out," said Mrs Mains. The Reverend Bob Peck asked if they would put those proposals to a vote at a meeting such as the one held last week, but the representatives would not accept this idea, however they did say the proposals would be open for discussion. "There will be some disagreement," said Mrs Mains. "We can't have every thing we want." Bed numbers cut Indications from answers to questions given by the board representatives were that there will almost certainly be cuts made to the number of hospital beds in the Waimarino, but that the Turnpage 3

Health board here "for information"

From page 1 board will retain some. While the board representatives stressed that they are in the early stages of gathering information before working on specific proposals, they did give reassurances that the maternity annex would remain and that some medical beds would remain. Mrs Mains said the statistics showed that the average occupancy of beds at the Waimarino Hospital was 10 out of the 19 available.

Cuts in the number of beds would enable the board to spend more money on community based care, such as providing a seven days a week district nursing service, more public health nurses to work on health education, Maori community health workers, a community midwife, staff to provide on-going maternity support at home to women who discharge themselves early from hospital and a full-time ambulance officer. Mrs Mains stressed however, that the number and type of beds that will remain at Waimarino and the types of services to be

set up are yet to be discussed. Better services with cost cutting Two motives for the board to make changes became clear at the meeting, one was that the board has had its budget cut by $4.5 million and expects its overall budget to remain the same next year. The other is to shift the emphasis from institutional based care, to community based care, or health care in the home. Mrs Mains said the board is looking at the nature of admissions at hospitals like Waimarino, which has one of the highest patient admission rates. She said it could be that many patients are being admitted when they could easily be cared for in their own homes, and be better off staying at home. Health promotion could prevent some hospital admissions long term, including education for asthmatics on how to manage their condition. Maori health A major concern for the board is Maori health, she said. While Raetihi is 43 per cent Maori and Ohakune is 35 per cent, Maori hospital admissions rate 66 per cent higher, pointing to a lower Maori health status. The board representatives said a shift in emphasis from just caring for the sick to promoting good health was necessary because the health status of ru--ral people is not improving.

The board sees a need to promote the idea of people taking over the responsibility for their own health. As for care for the elderly Mrs Mains said the board sees rest home care as being best provided through private rest homes or trust-run rest homes. Rob England said he was willing to talk to anyone who had ideas on how the Waimarino nurses' home could be turned into a rest home. Among questions asked of the board representatives, Bob Peck asked where there was a rural health centre currently operating successfully, to which the reply was that the idea was a collection of systems which are being run successfully in various places. Margot Mains said the WAHB was "trendsetting" in the field of rural health care. Health not improving "We've come here tonight to find out what's appropriate for the Waimarino," she said. "When you run a service that is 50 per cent occupied, you ask yourself why isn't rural health improving?" Linley Gregg, the area's new social worker, expressed concern that with the establishment of a rural health centre at the hospital the community health rooms might be seen as unnecessary but that in her work many people were shy of institutions such as the hospital, and that a more central place such as the health rooms

was more useful, especially in dealing with people with mental health problems. Mrs Mains replied that the location of the rural health centre was yet to be sorted out and that she agreed the mental health affects physical health.

She said if all the health services are under one roof the centre would become a focal point of the community and that they need to make people feel welcome to use the centre. She added that services will often be taken out of the centre when appropriate. Whanau Waimarino Hospital manager Eve Rush said Waimarino Hospital is not an institution, that it is run as a whanau and that she had never seen people "walking along walls" - as Mrs Gregg had described the felling of institutionwary, mentally ill people. Mathew Mareikura asked what assistance the board would give to Maori health care. "It is a concern to us to set up units to help look after our own health, not because there is a lack here in

Raetihi but because it is something we need to do ourselves," said Mr Mareikura. Mrs Mains said there would be an increase in spending on Maori health to help alter the imbalance in Maori health status and that they recognise the need for Maori people to address the issue. Jessie Seaman asked who pays for the doctor to visit if a patient is cared for at home, to which the answer was "the patient". At this stage a man said he believed the whole meeting was a way of telling the Waimarino the hospital was going to close and that once it was closed it would never reopen. Garrick Workman asked the meeting if

people felt they were talking about the hospital closing, most said no. "Where we've intended to close a hospital we've damn well come out and said it," said Rob England. He said because money is getting tight in the health sector the board had to be sure the Waimarino community is getting its $1 million worth. Jenny Decker asked if new mothers would have to be discharged early, but Mrs Mains said women would continue to have the choice of staying in the maternity ward. Specialist services Nancy Winter asked if specialist service visits would continue, i .

and was told yes, they wou'd. Neil McLean asked how viable the local doctors' practices would be under a rural health care system considering what was happening at Waiouru and Hunterville. Mr England said because the Waiouru Maternity annex had closed the Waimarino one would stay. He said it was a geographical necessity to have one in the Waimarino. Alastair McGregor said he couldn't see how , the closing of one ward could pay for all the services the board was talking about. He said the new service sounded more expensive. Mr England gave the Turnpage4

"There will be some disagreement. We can't have everything we want." T

"Where we've intended to close a hospital we've damn well come out and said it"

Health

From page 3 example of Patea hospital which cost $1.9 million in 1987 to run, $1.5 million last year and $900,000 this year. He said they had no specific costings yet but would have them worked out when they develop their proposals.