Air ambulances highlight pressures on rural medical emergency services
Most medical emergency response services in New Zealand operate on the passion and commitment of the people who provide it.
On an emergency helicopter, in an emergency ward, on any ambulance or fire service crew, you tend not to find people doing it for the money.
For most people there’s a safer, simpler and more lucrative way to earn a living than lifting people off mountains, pulling people from the sea, cutting people from cars in the middle of icy winter nights and attending to any number of serious accidents that occur outside of our urban centres.
We owe these people our gratitude, our support and, at the very least, the resources they need to complete their jobs as safely and effectively as possible.
It’s easy for many of us to forget that our cities occupy a fraction of New Zealand’s land mass. Most of our lands, our coastline, and our roads are in rural New Zealand, often hours away from even a modest hospital service. The dangers of our mountains, our lakes, our rivers and our forests all live in rural New Zealand.
Here New Zealand relies on a network of specially trained rural doctors and nurses who, between them, are on call 24 hours a day, seven days a week to provide the critical first responder emergency service when things go wrong outside of our cities.
It’s these people who are often on the air ambulances supporting this critical service. Otherwise, they’re driving either their own or practice vehicles to the sites of serious car crashes rural accidents and medical emergencies.
Through their support of the PRIME service (Primary Response in Medical Emergency), these rural health professionals save countless lives every year, often at considerable cost to themselves and their families.
This 24/7 essential service throughout 75 regions of New Zealand is provided for a total of $1.8 million in funding every year. As I said, these people aren’t in it for the money.
As you might expect, $1.8m a year is not enough. As the Network representing the rural doctors and nurses who provide this service, we’re now publicly calling for change.
What we’re starting to find is that the funding is not adequate to provide the basics. Many PRIME responders drive their own cars to accidents and until recently, many didn’t have adequate equipment such as hard hats or the high vis gear required. After riding back with a patient in an ambulance or helicopter, they often have to scratch around to get their cars back the next day – often from the most remote locations.
And we’re asking these men and women to do more and more, which is another reason why the funding is no longer enough.
Take, for example, the situation in Twizel. A permanent population of 1500 which, over the summer holiday period, jumps ten-fold to 15,000 people, mainly tourists.
It’s a doctor’s nightmare: alcohol being routinely consumed with all of the risk that goes with that; international drivers not used to our roads or our rules; inexperienced and under-prepared people flocking into the unforgiving Kiwi wilderness.
We hear a lot about the pressures that New Zealand’s booming tourism industry is placing on our natural environment and regional infrastructure. What we don’t hear about are the pressures of tourism on our rural health services. The New Zealand tourism experience that we market to the world is, almost exclusively, accessed via rural communities. As a country, we already struggle to recruit doctors into rural regions and right now the demands on our rural health professionals have never been higher.
Recently I was made aware of one rural doctor who, as part of his commitment to providing this contracted rural first-responder service, was called to six air ambulance events in his region in one day. Over that time his local patients were left sitting in his waiting room.
We cannot keep taking them for granted. I estimate that a minimum of a doubling of funding for this service is required to ensure it is adequately resourced. An emergency first responder medical service across all of rural New Zealand for less than $4m sounds to me like outstanding value for taxpayers’ money.
I appreciate all too well the demands on the health system, but this one feels like a relatively easy fix for a modest sum.
I’d like to see some recognition of the value of this service, and the increasing demands on it, in the Budget this month.
Dalton Kelly is chief executive of the New Zealand Rural General Practice Network, the only membership-based organisation representing rural medical professionals and practices.