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Reti takes region’s temperature

In what could be described as a bit of politically adroit due diligence as the National Party’s health spokesperson, Dr Shane Reti recently visited several Wairarapa health providers, and found time to speak with NICK GRANT about what he observed.

Such was the tightness of Reti’s schedule, he was already on his way out of the region – barrelling along SH2 towards Pahiatua – when he spoke to the Times-Age. Fortunately, the reception was good.

Reti had recently been making political hay – and copping some criticism in response – by seeking out an on-the-ground view of the state of the health system by accompanying ambulance crews on their night shifts.

During his visit to Wairarapa at the end of last month, his fact-finding tour included visiting Greytown’s Five Rivers Medical, Masterton Medical Centre, and an aged care facility.

One of his major takeaways was in line with what he’d observed in other parts of the country: “The huge impact that the lack of health workforce is having”.

“It’s definitely having an implication here in Wairarapa,” he said.

“What particularly sticks in my mind as an example is you’ve got a wonderful facility like Five Rivers that’s struggling to get a fulltime doctor, and that’s reflected across the wider region – there is a real deficit in the Wairarapa of those health professionals.”

Asked what he would do to remedy the situation, Reti took the opportunity to promote National’s policy to establish a third medical school, one that has a focus on delivering more doctors to rural areas.

Acknowledging that this is far from an immediate solution – the hypothetical institution wouldn’t have its first intake of medical students until 2027 – Reti outlined several interim fixes he is keen to pursue for plugging staff shortages.

“One of them is offshore and requires a change to the immigration settings. We’ve announced that we would give qualified nurses a six-month temporary visa without a job offer to look for work and to bring their immediate family members with them. This government was so late getting a day-one pathway to residency that I think that pool is a lot less than we’d all like to imagine. But that is one of the immediate areas we can go to,” he said, also referencing the intention to cover part of nurses’ and midwives’ student loan repayments – as long as they commit to working in New Zealand for at least five years after graduation.

“The second area I saw an example of this morning,” he said.

“Doctors who have qualified overseas come in and sit the Medical Council exam called NZREX. And then they can’t find a place in a hospital for the two internship years they need to be fully registered, and so they drive Uber Eats in Auckland.

“That makes no sense. They have no visa issues, they’re permanent residents, they’re well qualified. We’re in a crisis and we can’t take them on board.

“Well, in one of the medical centres that I visited here today, they actually have an NZREX doc, who they’re looking to progress through the appropriate stages, so that he can then take up full registration – and then he wants to work back in Wairarapa. I was really pleased to actually see exactly the model I think needs to be progressed actually being deployed in Wairarapa.”

The third area involves focusing on the retention of our health system’s existing workforce, via improved salaries and conditions.

In what may prove a popular pitch to provincial voters, Reti also took aim at what he described as the current government’s “ideology to centralise” the health system [among other things].

“I disagree with that and believe the vast majority of the decision-making should be pushed back out to the regions,” he said, noting the community organised covid-19 vaccination drives as an example of how effective a localised approach can be.

The apparent inability of the recently centralised Te Whatu Ora Health New Zealand to provide accurate data on how the system is performing also drew Reti’s fire.

“It’s really an example of abject incompetence. Explain to me why DHBs could put out monthly data, and Health New Zealand cannot? How is that possible? How could things have got worse when the promise was that the data would be centralised and all in one place?” – as did the government’s lack of emphasis on health performance targets.

“Here’s a clear differentiation between us and the current government,” he said.

“The minister has said targets will not be at the forefront of their health policy. I am saying targets will be at the forefront of my health policy. I believe the emergency doctor specialists who say that targets save lives.”

As for the suggestion from some quarters that he’d somehow been unethical in getting out among the frontline of the health system, Reti stuck to his guns.

“I make no apology for being out with the front line, trying to understand how we can do a better job at night. There’s just not a position where it’s not a good thing for a doctor to be out on an ambulance looking and learning and trying to understand how they can help.”

What he learned will help inform policy, especially about after-hours primary care where he said he’d observed a serious gap.

At the interview’s conclusion, apologies were proffered for the less-than-ideal weather Wairarapa had put on during his visit.

“This is why I live in the north,” Reti laughed. “It’s warm there.”

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