Rural people benefit from outreach health clinics - Primary Health Care at Work - Your Choices...Your Health

Your Choices...Your Health
Rural people benefit from outreach health clinics

25 October 2007

Deep in the Waikato are two small clinics reaching out to rural people whose many health needs were going largely unmet before the unveiling of the Primary Health Care Strategy in 2001.

Improving access to doctors and nurses

Central to the Strategy was that the health sector would no longer be about just treating illness. The sector was charged with helping people improve their health and maintain it – that included improving access to doctors and nurses that people in isolated communities may not previously have had.

Kai a Te Mata Marae Rongoa clinic

Three kilometres from Morrinsville at the Kai a Te Mata Marae operates one of only 12 accredited Rongoa (traditional Māori medicine) clinics. Since 1998, the practitioner has dealt with the health requirements of the Māori community surrounding the marae, in 2001 a GP joined them, providing once-weekly free clinics.

The Operations Manager of Waikato Primary Health, Erica Amon, says the GP was providing services at the marae virtually free and there was no guarantee he could continue in the long term. But under the Primary Health Care Strategy funding, his clinics became financially supported and assured.

“Dr Vince Murphy was the ideal person to send out to the marae clinic,” says Ms Amon. “He always regarded himself as a visitor (manuhiri) to the marae, and was sensitive to his place and role there. He took guidance from the kuia about the ways in which he should conduct his clinics so as to be culturally responsive to his patients”.

The marae was attached to a kohanga so Dr Murphy was able to monitor the health of the under fives, including their immunisations. The clinics also provided flu vaccinations and diabetes checks, as well as consultations for chronic conditions such as cardiovascular disease and asthma.

This year Dr Murphy’s wife Anne, also a doctor, began providing one of the weekly clinics at the marae, which proved popular with the women.

“Although we don’t have any definite figures, anecdotally we know Dr Murphy’s clinics were successful in reaching people who had previously been hard to reach. The Morrinsville Medical Centre was getting increasing numbers of patients enrolling, and the local pharmacist told us he was seeing people he had never had contact with before.

“The patients who attended the clinic had obviously grown more comfortable with seeing a mainstream doctor. They have a choice of whether to consult the GP or the Rongoa practitioner, or if they wish, they may even receive treatment from both. If they need to go to the Morrinsville clinic, the medical centre provides vouchers that pay the doctor’s fee.

Tragically, 55 year old Dr Murphy died in July, after an accident at home.

“It is a mark of how much his marae clinic patients thought of him, that after his death, a large procession of cars drove the 60 kilometres from the marae to Dr Murphy’s home in Hamilton to see his family. Another group attended and sang at his funeral.”

A colleague from the Morrinsville Medical Centre has taken over Dr Murphy’s role ensuring his good work continues.

Meremere clinic

A little further north, 20 minutes car journey from Te Kauwhata. is another outreach clinic, held in a community building in Meremere. Dr Geoff Knight and his wife Anne, a practice nurse, have held free twice-weekly clinics for the people of the low income and high needs community since 2003.

“The people in Meremere would end up at Middlemore Hospital’s emergency department because they didn’t see a doctor regularly and sickness became acute before they had contact with the health system,” Erica Amon says.

Now the community has become more pro-active about its health. “They have kids coming in saying they’ve got impetigo and need antibiotics. There are older kids bringing in younger kids to be seen. All in all, people are much better about managing their own health than before.”

Another aspect of the clinic is the free prescription delivery service. “If this did not exist many people would simply not get their prescriptions filled. Many of them don’t have cars and would not travel into Te Kauwhata to pick up their medicine.”

A community worker takes the prescriptions from the Te Kauwhata pharmacy and delivers to each patient’s home or the local dairy for them to pick up.

“The great thing about the Primary Health Care Strategy,” says Ms Amon, “is that you can have flexibility about the funding it provides. Both these clinics are the result of “services to increase access” funding, but the funding is used in slightly different ways to best meet the needs of each community.”

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Page last updated: 7 November 2007

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