An eye to Wairau's future
As a former senior nurse, I know how important it is for any community to have good health care facilities.
For our region, the retention of Wairau Hospital is our most important priority. To achieve that, we need some new thinking.
The terms of reference for the top of the south review of services state: "Leadership will need to encourage a new way of working, reflect innovation of practice." The focus being the "one-service, two-site model".
One of the major recommendations made by the review team was for the principles of natural justice, respect for human dignity, the common good, solidarity and subsidiarity should "undergrid" the strategic and operational framework from which "specific secondary care services evolve".
While the focus of our community was the retention of acute services, there are many non-acute services that could be expanded and developed to underpin and support the future viability of acute services at Wairau Hospital.
As I said at the recent health services meeting, Marlborough people requiring cataract surgery have to be virtually blind before they can get on to the waiting list. Many elderly Marlborough residents are simply not accepted for surgery as they fail to meet the points threshold required to access surgery.
There is a clear lack of sufficient affordable eye specialist services. Patients often resort to private care, sometimes opting to get one eye done at $3000. This perversely then reduces their chances of getting the other eye treated in the public system.
With help from Annette King through an Official Information Act request, I have discovered that the number of cataract surgeries completed at Wairau has declined since 2010 - from 132 to 110 cataract surgeries for the 2012 to 2013 period.
Failure to meet the threshold means many the elderly are being discharged and consigned back to their GP, to start the stressful process again to gain acceptance.
There is an average of 3704 people in the Nelson Marlborough region waiting for assessment and their first specialist appointment for a variety of elective surgeries.
The reality for Wairau is that the hospital will never be able to provide 21st century major acute surgical and elective services, simply because there is no intensive care facility capable of ventilating patients in the long term.
The lack of intensive care limits the hospital's capabilities and blunts its ability to attract surgical specialists and registrars. Therefore it is essential that the Nelson Marlborough District Health Board finds other ways of enhancing the scope and practice within the hospital.
Ophthalmology would be one of those fields. The surgery is low risk, simple, requiring minimal resources, but has a huge impact in improving so many peoples' lives.
Wairau Hospital could become the "eye hospital" of the South Island, attracting patients from outside the district, possibly importing some from Wellington.
Such specialities are not unknown. Wairau Hospital has over the past years developed a very good paediatric service that has grown from small beginnings. Developing an all encompassing ophthalmic specialist service could be something for the health board to support, having people in need coming into the district rather than travelling out.
Another option could be to develop ear, nose and throat specialities.
The demographic changes in the region point to a steadily increasing older population, who will require local services.
Currently Nelson-Marlborough have one in six people over the age of 65; over the next 10 years this will increase to one in five. The emphasis is to keep people in their homes, maintaining and supporting independent living.
Surely one of the primary health needs for our older folk is the ability to see, reducing the risk of trips and falls, and the further demands these would place on our health system, affording our elderly folk dignity, respect and certainty.
The Marlborough Express