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Dissatisfaction at Clinic!

The content of the front page story by Libby Wilson in the 12 April Hauraki Herald  on the intentions of medical practitioners to split' from the Hauraki Primary Health Organisation led by Hugh Kininmonth comes as no surprise.

The well intentioned move to place the PHO between the DHB and the clinics as a separate bureaucratic layer is a classical example of unnecessary excess, and Libby Wilson has done well to break through the silence that distinguishes everything within our health services.  Libby is very careful with her words, but it is clear that the apparent imbalance between Iwi, and private health providers is likely the root cause of the problem, with consequent perceived inequitable allocation of funding. It would be interesting to know just who elects the Boards of the PHOs - or are they simply appointed by the DHBs. 

The absolute anomaly here in Thames of Te Korowai (Hugh Kininmonth's previous employer) taking over part of the Thames Hospital adjacent to the outpatients department to run an additional and  completely separate fully subsidised clinic just 200 metres from the Thames Health Centre where all patients pay $38 to see a doctor, and $20 to see a nurse practitioner highlights what appears as unexplained discrimination being promoted within the health sector to the disadvantage of  all private clinics, and their patients. 

I sought an explanation under the OIA from the DHB at the time of the announcement of its intentions regarding Thames Hospital in January. Here is the content of my enquiry to the acting chief executive - David Nicholson:

 "Further to my letter dated 9 September, and your very full response dated 4 October, I would very much appreciate it if you could provide additional information in relation to the article that appeared on page 8 of the Hauraki Herald dated 4 January. (

In particular can I please be provided with a copy of the WDHB documents referred to by Te Korowai chief executive Rianna Manuel - apparently discussed at a Health Board meeting in December.

Further, can you please provide comparative information regarding the numbers of patients registered with Te Korawai, and the other Thames primary health care providers.

I seek this information principally in order to establish some basis for comparison between the patient load of Te Korawai, and that of Thames Medical Centre in particular.

This would appear relevant related to the claimed Te Korawai staffing of five GPs, four nurse practitioners, twelve registered nurses in clinics, and an unstated number of community based contract nurses.

With the current Te Korawai services providing “very low cost access” and “bursting at the seams,” it does raise a question surrounding the fairness and equity of consultations provided at normal cost  ($38) to people of equivalent socio-economic status to those serviced by Te Korawai from premises just 100 meters distant.

I would be grateful for any comment that you may be prepared to make in regard to this situation – plans for which appear well advanced.

I appreciate your attention to this matter."

I have yet to receive a reply to this enquiry, or even an acknowledgement.

It may not totally explain the dissatisfaction that is apparently leading to the withdrawal of of GPs from the Hauraki Primary Care Organisation, but it certainly would not have contributed to a harmonious relationship with the clinics, of which Thames is by far the largest, affected by the relentless expansion of Te Korowai's activities.

It certainly will not improve the relationship with patients receiving identical fee-paid services through their clinics, and points to a new and quietly growing inequity disguised by the clearly ill-managed rush to reverse a historic imbalance in health statistics.




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