Tag Archives: health

MORE THAN MATERNITY SERVICES AT STAKE


The massive downgrading of maternity services at Whakatāne Hospital is just the tip of the
iceburg. Investigations have revealed a hospital in crisis, with dedicated and highly
competent staff struggling to keep servicing the community within a dysfunctional system.
When news first broke that Obstetrics and Gynecology services were closing, the public
was told that it was just a recruitment issue and that secondary maternity services
(obstetrics) would resume in 12 months. After speaking to a number of staff within the
hospital, it is clear that there are far bigger issues that have led to this closure, and which
threaten other departments. The community has a right to know, and to make our voices
heard.
Recruitment is absolutely an issue, with a shortage of obstetricians globally, but more
importantly the recruitment process at Whakatāne Hospital is a shambles. A number of
departments have chronic staff shortages, but they get almost no recruitment support.
When they manage to find applicants, getting contracts signed off by the bureaucracy in
Tauranga can take up to ten months. The coalition organising Saturday’s Hikoi for Health
has heard of multiple examples of great people being recruited by local senior staff, but by
the time their contracts are approved they have moved on.
Other applicants have become so frustrated by the lengthy delays in getting a permanent
contract that they end up applying through a recruitment agency and being taken on as a
locum, at a higher cost and with numerous other disadvantages. Senior staff have
complained at being unable to identify where the hold ups are, with decision-making
unclear to locals. What is clear is that recruitment for Whakatāne takes a back seat to
Tauranga.
This is made worse by the lack of a local General Manager for the hospital, someone who
has oversight over the whole hospital, a local perspective, and who can advocate within Te
Whatu Ora for Whakatāne’s needs.
Even when people are recruited, staff shortages mean that doctors and nurses are
constantly under stress and exhausted, leading to people leaving. The Coalition
understands that of the four obstetricians who recently resigned, leading to the closure of
the unit, three had been recruited from the USA within the last couple of years. They
moved country, relocated families, bought houses here, only to move on within a short
space of time. This is indicative of a dysfunctional working environment and poor
management from Tauranga and our coalition hopes that those people will tell their tale so
the local community can understand what is going wrong at the hospital.
On top of all of that, succession planning seems to be almost non-existent. Te Whatu Ora
had plenty of advance warning of at least one of the obstetricians resignations but didn’t fill
the position, leading to gaps in the roster and only patchy coverage since last year. In
another department a doctor coming up for retirement gave a years notice, but the hospital
sat on it’s hand rather than proactively planning for it. There are enough cases that it
seems to be a systemic issue. Overseas recruitment is vital to keep the hospital staffed,
and at least 6 months is needed to allow to visas to be approved and families to relocate,
so succession planning is a necessity. The lack of dedicated recruitment staff also means
that silly mistakes get made. Recently a number of new staff had to be put on hold
because they had applied for the wrong visa, following faulty advice.

Some of the problems are not new but recent moves to a more centralised system have
made it worse, with Whakatāne staff having little autonomy to make decisions about what
is best for our community. Added to that is cost cutting driven from Wellington, including
the downgrading of the back office functions that front line staff rely on to do their job.
I am deeply disturbed at what has come to light since the closure of Obstetrics and
Gynecology services. It is apparent that a number of other department’s are on the edge of
collapse. We cannot allow this to happen. Whakatāne has always had excellent medical
services, as many of us know from personal experience. We need to join together to fight
to keep them.
The Hikoi for Health Coalition is a broad coalition of people behind the Hikoi for Health
thus Saturday. Members come from a wide range of backgrounds and ages and from
across the political spectrum, united in their determination to protect local medical services
and staff . They include concerned members of the community, health professionals, as
well as representatives of organisations such as Whakatane Action Group, Whakatāne Act
Local, NZ Labour and the Green Party.
We are not medical experts but from talking to people who are, it is clear that there are a
number of things that could be put in place straight away to ease the situation. Allowing
heads of departments to appoint staff to vacant positions without having to go through
Tauranga is one. The appointment of a local General Manager to the hospital is another.
Third is to appoint some recruitment specialists. Lastly Te Whatu Ora needs to improve its
management of people and rosters and support our amazing medical staff. We will be
marching on Saturday Feb 15 at 12 noon from Mitchell Park to call for urgent action to
reinstate full maternity services in Whakatāne, and to fix the broader systemic issues at
the hospital.


Published in the Whakatāne Beacon 12/02/25

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MAKE OUR VOICES HEARD ON OBSTETRICS CLOSURE

The decision to close down secondary birthing services at Whakatāne Hospital will put mothers and babies at risk. Not just in Whakatāne, but across the wider Eastern Bay area and up the coast. It means that only low risk births will be supported in Whakatane, with an estimated 300 deliveries a year having to transfer to Tauranga. That’s a long way to go in an emergency. Whānau will have worse outcomes and reduced choices. We cannot allow it to stand.

The closure has already taken place, last week. We are assured it is temporary, and that the service will reopen in 12 to 18 months, once new specialists can be recruited. I find it hard to believe that this will actually happen. My concern is that it will become the victim of a broader push by this government to slash spending in the public health service. This is already happening in other areas of healthcare. Once we have become used to the lack of services in Whakatāne it becomes too easy to just let the restart deadline slide, and keeping sliding, until it just becomes the new normal. Even if that is not what Te Whatu Ora intends right now, without a strong community pushback other priorities will come to the fore as local health bosses grapple with increasing central government demands for savings.

We are told that the service is closing because the hospital has not been able to recruit the specialist staff needed to run it. There has been some internal criticism that they haven’t been actively recruiting, and that the shortage of staff was foreseeable. Could this closure have been avoided? I am not an expert and I know how easy it is to criticise people when you don’t have all the facts. I believe that Te Whatu Ora regional leadership has done the best it could do with what it had. The question for us as a community is how do we make sure that our opposition to the closure is heard, and that we don’t allow it to become a permanent thing? Taking Te Whatu Ora at their word, how can we best support them to ensure that the funding is there to restart when new staff have been recruited?

It is not Council’s job to fix the public health service. We don’t have the expertise, the resources or the mandate. I do think it is council business, however, to talk about the closure of critical local medical services, to advocate for our community and to pressure the government to do better by this sub-region. We are a growing area and right now the Government should be investing in us – in housing, in workforce development, in business support, and yes, in increased medical services. It is not a time to go backwards.

The pressure must come from the community. It is about our willingness to stand up for ourselves. A number of people have said that we need a march to demand the reopening of the service, and after talking to Kat Walsh (who started the petition) and others I am putting my hand up to be the contact point. We need to keep this issue on the table and not allow it to slide into oblivion. A strong show of support from the community will make a huge difference right now, to make sure the issue doesn’t get forgotten. If you are willing to help organise the march, please get in touch. We need a strong team of us to make it a success.

Following a successful march, I think there are a number of other things that the council can do to support the community. It just takes some political leadership and skill. Council is not just about roads and water pipes. Civic leadership, backing our communities and supporting local action on important issues like this are all part of a council’s role.

If you can help organise the march please contact Nandor at <nandor.tanczos@whakatane.govt.nz> or 021 887 011

Published in the Whakatāne Beacon 22/01/25

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My Submission to the Covid Inquiry

QU ONE: LOOKING BACK
My father died on 15 March 2020 of a heart attack. He lived in the UK and my mum phoned at midnight to tell me he was lying dead on the kitchen floor. What should she do? Could I come over? I said yes, of course.

It soon became apparent, however, that if I flew to England there was no way of knowing when I would be able to return. A pandemic had just been announced by the WHO and travel restrictions were starting to be put into place on the 16th. Could I leave my wife and children alone for who knew how long, and take the risk of flying into an epicentre? I decided to stay in Aotearoa and look after my family. Luckily my brother also lives in the UK and was able to help my mother navigate the autopsy, cremation and managing the financial affairs in the bureaucratic chaos that the UK was becoming.

That was very hard for us all. It was 3 years later that I was able to see my mother and visit my father’s grave.

Many people suffered as a result of the pandemic, many far worse than me. But no one is to blame. Well perhaps we all are. There are too many people on the planet and maybe nature is trying to bring us back into balance. In any case, in humanitarian terms our government’s response was largely the right one, and many thousands of people are still alive because as a nation we chose to follow the science and the evidence we had at the time. It angers me that some people would try to belittle that, or deny that covid was real or as serious as it was. I recall following the John Hopkins University website and watching the numbers of fatalities tracking up. I read up as much as a lay person can reasonably expect to about the efficacy of the vaccines and the value of lockdowns. As someone who is instinctively sceptical about vaccines, it became obvious to me that the vaccine saved lives. Yes being vaccinated carried risk. Like all medication, some people suffered side effects. But the evidence was clear that the risks from not being vaccinated were far greater. I think NZ was very lucky to have leaders who made good decisions on our behalf. Other countries with poor leadership suffered great loss of life compared to us.

Not every decision was perfect. I think the way lockdown was imposed placed real hardship on small businesses and advantaged large corporations. I think the way subsidy money was handled was open to abuse and again the money disproportionately went to the wealthiest corporations. The economic impact could have been more equitably handled. We could have used it as an opportunity to bolster local self reliance rather than more dependence on long supply chains. We could have used it to promote health and well-being alongside vaccinations messaging instead of allowing it to be seen as an either/or. We could have done more to promote equitable access to essential medicines on a global scale. Lost opportunities.

Also some of the communications were poorly messaged. While the regular updates were great at keeping people informed, phrases like ‘single source of truth’ and ‘social distancing’ (as opposed to the more accurate ‘physical distancing’) were not helpful. The government could have done more in countering misinformation.

Having said that, it was hard to predict the sheer craziness that would erupt, fuelled by international money funding local grifters. That they managed to pull in so many well-meaning people who had justifiable questions about the impacts of the policies is an indictment on Government communications. That some became cult followers living in an information bubble and disbelieving anything that contradicted their viewpoint is a tragedy.

I am a decision-maker in a large organisation. We introduced a vaccine mandate for all staff who interface with the public. We lost people over it and were heavily criticised by a small number in the community. Front line staff faced verbal and physical abuse because of those decisions, although we did our best to maintain services for all, vaccinated and unvaccinated alike. It was a difficult decision but I have no regrets about the stance that we took. Our priority was to safeguard the health and well-being of our staff and our community. Most people in our community understood why we took the position we did and supported us. People absolutely have a right to choose whether or not to receive a vaccine, or any other medical treatment. They do not have a right to put others at risk. Choices have consequences – not as a punishment, but in terms of minimising the potential impacts on others.
The lesson for me in that is that it is easy to read too much into the strongly held opinions of a small number of people. Their concerns shouldn’t be ignored, we should learn from them, but we shouldn’t over-react or think they represent the views of most people. This inquiry will no doubt hear lots of submissions from militant anti-vaxxers. Some of those will misrepresent what happened, deny the scientific evidence, and fabricate events, either deliberately or simply because they truly believe things that are false. For example I had a friend who I trust tell me that their partner had adverse effects from the vaccination. The partner denied it when asked, and from their story it seemed like it was an exaggeration of events. I do not think they meant to lie, but that their perceptions were so biased as to mislead them.
So it is up to you, the commissioners, to look honestly, soberly and robustly at the evidence and provide some impartial answers to people’s many questions. No doubt whatever you say, you will be criticised and attacked. I encourage you to pay no attention to that and just present your views as honestly and impartially as you can. Thank you.

QU TWO: LOOKING FORWARD
As I mentioned in the first question, I think the things we need to learn are:
1. To think holistically and in an integrated way. For example, how can we use an emergency such as a pandemic, and its recovery, to achieve multiple social-economic aims such as boosting local economic self-reliance and circular economies, encouraging individual health and well-being alongside pharmaceutical interventions, looking after our most economically vulnerable instead to defaulting to throwing money at the wealthy.
2. I would like to see us do more as a national to support the freeing up of pharmaceutical IP rights to allow more equitable access to essential medicines such as vaccines across the globe. Too often NZ seems to take a position on the world stage of bolstering corporate rights over the rights of people to access medicine, and the common wealth of the body of scientific knowledge.

3. We need to be better prepared to counter misinformation by global actors driven by ideology rather than by scientific evidence.

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