Study highlights dangerous disconnect rural hospital face as spectre of Covid-19 looms


Rural hospital doctors are reporting a lack of support from DHBs during the first Covid-19 outbreak, in new research by the University of Otago.

Small rural hospital in Waipukurau.

Small rural hospitals like this one in Waipukurau have been forgotten about, research suggests. Photo: RNZ / Anusha Bradley

Dr Kati Blattner, from the University of Otago, says there is a disconnect between different parts of the health system, when it comes to transferring patients, that often ignores both local expertise and the geography.

“This research puts the spotlight on a sector of our health system that’s generally invisible, as we see it out here, at the end of the dripline,” she told Morning Report.

The study involved interviewing 17 senior doctors across New Zealand in 17 different rural hospitals about their experiences planning for the pandemic. It looked specifically at issues in the way of transferring patients to other bigger hospitals so they could receive advanced respiratory care.

“It means negotiating access, getting a transfer accepted, organising either an ambulance or a retrieval by helicopter,” Blattner said.

The barriers were evident. St John’s policies, for example, don’t accommodate transferring anyone with respiratory problems.

“St Johns itself as an organisation is great,” she said. “It’s just a disconnect between the three players here. A disconnect between the local health services in local areas. They have a lot of expertise in their own geography and their own people.

“Then you have the regional DHB’s plans and policies and you throw St Johns’ national policies and procedures into it and you get this interface, which is not cohesive for patients in rural areas.”

Blattner works in the Hokianga in the Far North. She said some some progress has been made since 2020, but the issue of rural hospitals being neglected remained and is a continuing cause of worry as Covid-19 begins to spread into communities, she said.

“There’s good nation-wide support for general practice and for different specialties, but rural hospitals are forgotten about and that puts our rural patients at risk and our rural health professionals also.

“It’s just about understanding that rural context and what would be great would be if the DHBs in their planning for patient scenarios, patient journeys, factor in the rural hospital as part of that journey.

“So, have the leadership, especially the Māori leadership, representing rural hospitals at the table when they start talking about planning, not just throwing the plan out to us when they’ve already made it and then we scramble to try and stick to the plan.”

She says rural hospitals are working hard to serve their communities but action needs to be taken to support those efforts.

Rural communities are now worried about the Christmas period, when people coming to visit for holidays and now the local health services would cope with the spread of Covid-19,” Blattner added.

“If the study does nothing else but raise awareness around the country that rural health services and hospitals are only just managing to meet the needs of the rural communities,” she said.

She said rural communities are now worried about the Christmas period, when people coming to visit for holidays and now the local health services would cope with the spread of Covid-19.

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