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DHB at ‘tipping point’


Time is now to ‘reset course’ for future of community health
‘No good organisation stands still’

[email protected]

Wairarapa Hospital’s model of care is “out of date” and at a “tipping point”, creating safety issues for the community, a report says.

The Wairarapa District Health Board plans to “reset the course” of the health system for the next five to 10 years to fix fundamental problems such as health needs not being met, the hospital and primary care being “out of capacity”, and staff being “increasingly stressed”.

A report by the DHB, Direction for Health Services in Wairarapa, states a “major shift” is needed to address challenges in healthcare.

This includes creating a fit-for-purpose hospital, integrating health and social services, and strengthening primary care.

“We can’t ignore the fact that the DHB has a significant deficit and needs to find its way to financial sustainability,” the report said.

“We need to determine what sort of hospital we need in Wairarapa and ask ourselves, ‘are we trying to do too much?’.

“Sub-specialism fragments the workforce and makes a hospital this size unsustainable.

“Essentially, we are trying to recruit senior doctors to an outdated hospital model.

“Creating a fit-for-purpose hospital essentially means a hospital reset, avoiding providing services in the hospital that do not need to be there.

“We will consider a rural medicine hospital model with a workforce of primary and secondary ruralists and visiting specialists.”

Wairarapa has experienced higher than expected population growth in recent years – particularly among Maori and older people – and as a result, there have been inequities in health outcomes for these groups.

Growth projections show Wairarapa’s population will increase by 16 per cent over the next 20 years to more than 50,000 people.

As a result, general practice would need to provide an additional 280 consultations a day – roughly equivalent to the workload of 10 general practitioners under traditional models of care, the report said.

“It is clear we need a major shift in the way we do things if we are to achieve equity for our population, meet future demand, and ensure that services are sustainable for the long term.”

Regarding the DHB’s workforce, the report said it was a “serious challenge and that the current state is, in some parts, only just holding together”.

“There is a high use of locums across the hospital and recruitment is difficult.

“Equally, recruitment of general practitioners in the community is challenging and represents a major cost for some practices.

“While there has been success in developing nurse practitioner roles, both in community and hospital settings, the workforce is stretched, and the long-term prognosis is for this to become even more of a challenge.”

There are also issues in the way hospital services are delivered, with “inefficient workflow for ED [Emergency Department] staff, full wards, and long average length of stay”.

The report was included in a recent DHB meeting agenda however the meeting was cancelled due to isolation requirements.

Chief executive Dale Oliff told the Times-Age, “We have been very clear that in order to serve our community in the best possible way, we must make some changes.

“Our population is growing, our resources are under pressure, and across the health system our workforce is challenged. And none of these things are new to us. We have been communicating the issues for some time.

“What is new, is the way in which we aim to manage these constraints in order to develop a better approach to care that is targeted to meet our needs.

“No good organisation stands still, and our changing environment demands we flex and adapt to the needs of our population. We are a relatively small region, with good relationships across the services and the ability to be nimble. These are excellent advantages. Building a sustainable, equitable healthcare model is not just desirable, it is pivotal.”

Oliff said “now” was the time to make changes.

“The challenges will only get tougher. This is why a lot of work has gone into identifying the key areas of activity where we need to focus first.”

The DHB has been meeting with healthcare providers and community leaders, and said the appetite for change was strong.

“We need to adapt now in order to meet not just our current demands, but also tomorrow’s needs, as well as focus on a more effective service that improves outcomes for our people.”

Oliff said she welcomed community input.

Queries, comments and concerns are invited by email to [email protected]



  1. I don’t see anything above on mental health, and having experienced visiting a friend in the MH Unit, I sincerely hope mental health is part of the DHB reset vision. But I expect it won’t.

  2. hi guys, but if you are struggling so much. Why not sell the hospital to a private southern cross. We get better service and you get out of the red. Know business should be running at a loss. Like you said spend some time think about the future and sell. Funny this you should have done this 10 years ago, as you are just delaying the future. The community thinks why should we pay. I know I would rather pay to get a better service.

  3. As a member of the community who has had cancer twice I’d be up for providing some input but have got no idea what this bureaucratic babble means in terms of actual services. I had a phone consult with a cancer specialist in Wellington during lockdown and it worked fine. Nice chap newly arrived from UK. I was able to tell him how quickly he would become a breast cancer millionaire here.

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