4th November 2011, Volume 124 Number 1345

Roger M Ridley-Smith

If you have half an hour to spare, go to www.waikatodhb.govt.nz and roam around the cluttered website “Waikato District Health Board – Caring for You.” It will be of particular interest if you happen to live in the area and you are one of the 365,730 people that this body looks after. The figures supplied are getting better all the time and it is moving into more and more new fields. The Board has 6,000 employees; it had 4,800 in 2001. The budget this year is $1.1 billion dollars, over double that of ten years ago.

The Annual Report confirms that the Board last year arranged 142,368 mental health community visits, and about the same number of district nurse community visits. There were thousands of outpatient visits, but we note the 20,724 “did not attends,” and they are estimated to have cost the Board $3.11 million.

Click on “Meet the Team.” This site has nothing to do with doctors or nurses, but there you will learn that “effective communication is central to good management practice and crucial to building and maintaining public confidence.” The Media and Communications Team has provided some photographs of themselves. There appear to be sixteen of them, doing everything from patients’ records to graphic design and desk-top publishing.

There is a page somewhere headed “Health Professionals,” and it is “aimed at GPs and other health professionals.”

Click on “Thames Hospital,” run by the same Board. This secondary hospital gets plenty of attention, and that is hardly surprising, because, apart from the contented state of the maternity services provided in the Thames-Coromandel region, the evidence on the website suggests that the provision of emergency medical services is a perpetual source of anxiety.

Consider this. The population normally served is 44,000. Over the summer months it swells to 200,000. Thames Hospital copes with a staggering 13,000 ED attendances per year, and that number is increasing by ten percent per annum. Of these attendances, one-third are made by persons over sixty-five years of age.

“The hospital is staffed by four general physicians, three general surgeons and a visiting geriatrician supported by registrars, and medical officers/senior house officers. There are two anaesthetists and Emergency Department (ED) doctors who are specifically trained. Medical officers/senior house officers cover low risk inpatient surgical patients during the weekend. A physician is on site or on call at all times. ED doctors are also on site 24/7.”

Surgeons and anaesthetists are not available weekends. The Hospital is 100 Km from the Waikato Hospital and the time for the journey is given as ninety minutes.

The site informs us that six general practitioners in the town will, in rotation, work a six-hour shift in ED on Saturdays to relieve the strain. You can pick up on a helpful Question and Answer section regarding this involvement of the GPs in the hospital. One of the questions reads as follows;

Q. What if you don’t want to be seen by a GP?

A. If you choose not to be seen by a GP you will experience a longer wait for an ED doctor.

After a few hours wait for attention, any GP can begin to look good, but in the Emergency Department, “best practices and lean thinking guide practice improvement and change.”

Although there are no photographs, or even any mention, of the individual doctors in the employ of the Waikato DHB, there are photographs of the Board members, and of the administration team, and, when you go to the Thames Hospital section of the site, you are invited to “check out our wonderful team of midwives,” some of whom have graciously agreed to be photographed.

Twelve midwives are listed. These include Jane, for whom “birth is a miracle,” and Sandy, home birth specialist. They all appear to have the use of a brand new Birthing Unit, which is equipped with a birthing pool, birthing slings and birthing balls.

Deliveries in the Unit total about 100 per annum, i.e. two a week. The midwives are at pains to book and manage only low-risk patients, and, as Lead Maternity Carers, they can make all their own decisions.

If, on balance, you would rather see a GP for your medical problems, you should go to www.finda.co.nz , and type in “Thames Medical Centre.” If you want to know who works there, you will have to phone up and ask.

Roger M Ridley-Smith
Retired GP
Wellington, New Zealand

Author Information

Roger M Ridley-Smith, Retired GP, Wellington, New Zealand