Rural people are underserviced by the current health model, according to Dr Fiona Doolan-Noble from the Department of General Practice and Rural Health at Otago University.
SDHB’s Lisa Gestro – executive director strategy, primary and community – told Rural News its maternity services in the entire region have already been systematically reviewed. This comes in response to a Rural Women NZ (RWNZ) call for a wide ranging review.
“It has been independently reviewed and found that when fully implemented it will increase services across the district,” she says.
“We’re one year into a two year implementation timeframe.
“We recognise that some aspects of this have not gone as smoothly as we’d like and are having the implementation to date independently reviewed.”
RWNZ and others -- including signatories of two petitions -- are strongly objecting to the downgrading in April of Lumsden Birth Centre to a maternal and child hub and several subsequent emergency births at the centre, one in the carpark.
RWNZ has called for urgent reinstatement of the Lumsden birthing centre and has criticised the extent of two current reviews by Southland DHB. But Gestro says a systematic review of primary maternity services across the DHB’s entire, largely rural, district was precisely the exercise done from 2016 to 2018.
“There had long been calls to address the provision of maternity services across the district,” she said. “In particular, we faced challenges with the sustainability of the lead maternity carer (LMC) midwifery workforce.”
Gestro says while LMC midwives are paid directly by the Ministry of Health, SDHB recognises the particular challenges of practising in rural areas require extra support.
She says the ‘integrated primary maternity system of care’ aimed to take a holistic view to direct resources differently and increase the reach of services across the whole district.
“This meant creating maternal and child hubs in Wanaka, Te Anau and Lumsden to support midwives in those communities and improving integration with primary care services.”
Additional ‘sustainability’ payments are made to remote rural midwives, with 16 LMCs in the district taking the extra payment.
But Gestro says they need to think more broadly about how best to use their resources to care for rural women and their families.