Health NZ to front community Palmerston North loses last gastro doctor

Palmerston North Hospital's last gastroenterology doctor has now left

Dr James Irwin says he will continue to advocate for better health services in provincial areas

Health NZ says gastro services are continuing and recruitment for new specialists is under way

Public meeting about issue scheduled for Monday.

The last permanent gastroenterology doctor has now left Palmerston North Hospital, leaving the region's digestive health needs in the hands of locum and temporary specialists.

The hospital is funded for just under six full-time gastro specialists, but it doesn't have any at present, after Dr James Irwin's last day on 19 June. He's watched his colleagues leave in the past couple of years.

Health New Zealand Te Whatu Ora says it wants to reassure the community gastro services are continuing and that recruitment is under way.

Senior representatives from the organisation, as well as Dr Irwin and others, will speak at a public meeting organised by senior doctor union, the Association of Medical Specialists, about the situation on Monday evening.

Doctor vows to fight for region

RNZ caught up with Irwin last week at the hospital as he returned to tie up loose ends.

Irwin became emotional when speaking about his decision to leave, due to workload pressures, after more than a decade.

"I feel really guilty about having resigned, for the patients I looked after and all the staff who are still at the hospital, particularly all the nursing staff there.

"It wasn't a situation in which I felt I could continue working in any capacity for any reasonable length of time.

"I'm hoping that Health New Zealand are able to make some changes to the way they recruit to provincial hospitals in New Zealand, to alter the landscape."

Irwin said it was hard to recruit New Zealand-trained specialists to smaller areas, so incentives were needed. Otherwise working in bigger cities, with colleagues for support and less on-call work, would be too hard to resist for many.

Irwin though said the idea of moving to a bigger city held no appeal for him and he wanted to stay in Manawatū and use his experience to advocate for change.

"I feel strongly that Te Whatu Ora has a responsibility as a state organisation to prove good healthcare everywhere in New Zealand. That may cost more."

Otherwise, he's not sure exactly what the future holds, apart from some work at a private hospital and in research.

Irwin said he'd considered what he wanted to say at the public meeting.

"I value fairness and I'm a strong advocate for the community that I'm a member of here in Palmerston North.

"I want to fight for the people of this region and try to encourage Te Whatu Ora to treat us fairly and give us a similar service to what's provided elsewhere."

Long-term patient concerned about temporary staff

Health NZ has recruited a new specialist from overseas who's expected to start in September.

But even then it will still have to lean on temporary and locum staff while it works to fill other positions.

Irwin said his main concern was continuity of care for long-term patients. The department was doing well in providing endoscopy services, something that had previously been of concern, outsourcing many, but caring for patients with chronic conditions was less easy, he said.

One of those patients is Julia Russell.

The 37-year-old has had contact with gastro specialists in Palmerston North since she was a teenager. She moved back to Palmerston North from Auckland four years ago to be near family for support.

Russell said she saw Irwin every six months and was lucky to have an appointment with him shortly before he left.

Her main concern now was that lack of continuity.

"With your consultants you build up a partnership and trust. With a new doctor or locum coming in, there's a lot of history to learn."

Russell said explaining her story would take up a good chunk of any appointment, and it was something she didn't want to do all the time.

She has irritable bowel disease and said negotiating that involved working closely with a gastro specialist to look at treatments and their effects, including managing side effects and symptoms.

"I'm unsure, uncertain. I'd be scared if I had to go to hospital now."

Services continuing - Health NZ

Health NZ said it had a plan in place to support the gastro service and "over time" improve access to care.

Its executive regional director of the central region, Chris Lowry, said patient safety remained a priority.

"We want to reassure our community that essential gastroenterology services are continuing, and patients with the most urgent clinical need are being prioritised and cared for.

"We acknowledge that this has been a challenging period, and we are focused on strengthening the service and improving access as quickly as possible."

She said there was "strong regional collaboration" to support the service - where specialists from nearby regions were called on, as well as using locum and temporary specialists for clinics and endoscopy services.

Referral and triage processes were improved and patients were prioritised based on clinical need.

As well as the specialist starting in September, other "additional candidates" were "progressing".

Lowry acknowledged the challenges in recruiting specialists.

"We are continuing to explore all options to attract clinicians to MidCentral and build a sustainable workforce for the future," she said.

"We are currently offering an onboarding allowance and an allowance paid at the end of 12 months while we review remuneration for provincial services."

Health NZ recognised the effect of the situation on patients and their families, and understood it was frustrating some people were waiting longer than they'd like.

"We are committed to improving access and keeping patients informed," Lowry said.

* The public meeting is at 5.30pm on Monday at the Massey University Sports and Events Centre, Albany Drive, Palmerston North. Doors open 5pm.