It’s scalpels at dawn

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Queenstown doctors are at each other’s throats over the carve-up of the resort’s only hospital. 

A rival group of medical professionals has emerged opposing Southland District Health Board’s controversial proposal – which is broadly supported by Queenstown Medical Centre – to turn Lakes District Hospital into a partly-privatised facility run by GPs. 

The group, comprising LDH doctors, nurses, midwives, and GPs from practices not aligned with QMC, is fizzing about the lack of SDHB consultation. 

It believes the board is trying to “wash its hands” of the Wakatipu, group spokeswoman and long-
time local doctor Val Miller says. 

Miller claims: 

? Private practice powerhouse QMC helped write the recent public consultation document for SDHB 

? The proposal to have GPs decide whether patients should get free emergency care flies in the face of a newly-released Ministry of Health directive 

? LDH emergency department (ED) doctors “are not comfortable with handing their contracts over to a private operator” 

? The current proposal creates a “monopolistic situation” 

The group is so concerned it’s asked SDHB boss Brian Rousseau for extra time to write its own alternative that will be “more community-orientated”. 

“I don’t think the community is really aware of what could happen if [SDHB] were to follow the current proposal,” Miller warns. 

|“It means that somebody with a financial interest will be the gatekeeper of the hospital and that is a serious concern and does go against Ministry of Health guidelines. 

“I think it’s essential that we maintain the hospital structure as it is, with an ED that’s not financially interested – that’s for the good of the community and the continuation of strong healthcare.” 

Miller, a partner at Wakatipu Medical Centre, maintains QMC – which has 12,924 enrolled patients – worked on the “health services delivery” proposal with SDHB “for a considerable length of time, dating back to well over a year ago”. 

“We know it’s QMC because they put people on notice that they’re ready to run with it…” 

She adds: “Members of the district health board were not familiar with the document until it was presented to them at the same time it was presented to the community [in March].” 

QMC boss Dr Richard Macharg denies the publicly-circulated proposal was QMC’s but admits “we have had discussions and been consulted by [healthcare advisers] Cranleigh Health”. 

Macharg also avoids any suggestion of a monopoly – he says QMC’s submitted a proposal to SDHB suggesting several service providers should be involved. 

But QMC’s proposal would still have private GPs at the gateway. 

The fact that Queenstowners would have to pay for their ED non-hospital treatment while people in Invercargill and Dunedin automatically receive free ED care is “an anomaly which we are not in charge of”, Macharg says. 

Miller believes Rousseau has “looked for a quick fix” to ease the huge deficit that Otago and Southland DHBs face, which has insulted hard-working LDH staff. 

“The doctors at the hospital feel quite strongly that the ‘seriously over-budget’ argument has been often taken out of context and skewed to make the situation look worse than it genuinely is,” she says. 

“It then sets the way for getting rid of LDH to an independent operator – when in actual fact, if you look at the figures differently, the deficit is significantly less.” 

Meanwhile, Mountain Scene has obtained a Ministry of Health paper on the “principles and expectations for the interface between primary healthcare services and emergency departments”. It says patients shouldn’t be denied free ED treatment “for humane and clinical reasons”. 

“…Triage should not be used to obstruct access to, or ‘triage away’ from EDs,” the report says. 

Miller says free hospital ED care “provides the opportunity for somebody who realistically does not have the money to pay to still be given basic healthcare – that is the right of all New Zealanders”