Diabetes service fights axing

MARTY SHARPE
Last updated 05:00 13/02/2014

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A succesful diabetes service has been canned by Hawke's Bay District Health Board, because it costs too much.

Now the service has hired top Wellington law firm Chen Palmer to fight the decision, and the board's chief medical officer for primary care was questioned by MPs at a select committee yesterday.

The board has discontinued $150,000 annual funding of the specialist diabetic service run by Janet Titchener, because it serviced only 1.2 per cent of 7990 diabetics in the region.

The DHB says Titchener's service costs about $1500 a patient, while specialist services provided at Hawke's Bay Hospital cost $500.

But Titchener and her supporters, including other doctors, say the service - which has been running for eight years - was intended only for those most affected by the disease, so was always going to help a small number.

The outcomes of the service have been independently assessed as resulting in better than average improvement in patients, with Maori and Pacific Islanders improving at a greater rate than elsewhere.

Titchener said cancellation of the service, when her contract expires on March 31, would end up costing the board more, not less.

"The DHB claims it is saving money by stopping its funding for the service, yet the service is saving the health board tens of thousands of dollars. These savings are immediate and exponential over time."

Of the region's 130 GPs, 128 had referred patients to the service.

A letter from Chen Palmer to the DHB outlines what are claimed to be flaws in the board's review of Titchener's service, and claims the decision to cancel the contract was pre-determined, misguided, and not in the interests of the region's health.

The service reduces healthcare costs by 37 per cent per person per year, meaning the DHB's investment is repaid within two to three years, the letter states.

Chief medical officer for primary care Mark Peterson said the board was in the process of responding to the letter.

There was no dispute that Titchener "does a good job for her patients", he said.

"The problem comes down to allocation of resources and it's a particularly expensive programme she runs, to a very small group of patients. We think the money could be spent on similar programmes to a greater number of patients for the same amount of money."

Peterson was questioned at a health select committee meeting in Parliament yesterday by MP Annette King, who asked for a rationale for the closure of the programme, despite its success.

He outlined the cost arguments, and said the programme's referral process was "a little loose" and "purely at the behest of the general practitioner - in fact, there was no screening or triage of who could be referred".

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- The Dominion Post

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