SCDHB

Statement on behalf of Chris Fleming, Chief Executive, and Murray Cleverley, Chair.

This was read out at the Temuka Grey Power meeting on September 22, 2011, by Arlene Goss.

Good evening. I am Arlene Goss, the Communications Manager for the South Canterbury District Health Board.

Chris Fleming - the Chief Executive Officer - has requested that I attend this meeting on behalf of the DHB.  The purpose of my attendance here tonight is to listen very closely to the discussion and take down any ideas that may arise from the meeting. 

Both Chris and Murray Cleverley, the Chairman of the DHB, have asked that I read out this statement on their behalf.

The principle reason why Chris Fleming and Murray Cleverley are not here tonight is because there is currently a contractual dispute between South Canterbury District Health Board, South Link Health, and the General Practitioners involved - and there is due process - including potential legal avenues - to be followed.

It is inappropriate at this stage, for legal reasons, for the District Health Board to actively participate and enter any debate in this forum.  Chris, Murray and the board members apologise for having to take this position, and do not wish their apology to be seen as representing any reluctance to find a sustainable solution to after-hours GP services for the people of Temuka and Geraldine.

Mediation - which was planned for last week - was delayed for valid reasons, and we are attempting to have this rescheduled. At this stage it is likely to be during the week of the 3rd of October.

The district health board, South Link Health (the Independent Practitioner Association), and the individual general practitioners have various contractual relationships which identify their obligations to each other, and to the people of South Canterbury. 

The district health board contends that the actions taken by the Temuka and Geraldine GPs -(excluding Dr Moginie) - breaches their contract with South Link Health,- and in turn South Link Health have been placed in a position - by these actions - of a breach of their contract with South Canterbury District Health Board.

Our respective contracts set out the process to be followed in the event of a dispute. This firstly includes mediation; and if that is not successful then arbitration. In the meantime we are all expected to comply with our obligations under the Agreement until the dispute is resolved.

Unfortunately one of the key issues in the dispute is each party's obligations. This presumably has led to the GPs believing they are within their contractual rights to withdraw from the provision of after-hours services. 

The district health board believes it is important to state the following:

First, we have undertaken a review of rural funding.  This review confirmed that Temuka does not meet the criteria established nationally for rural funding. Geraldine continues to meet the criteria. While the action of reviewing rural funding has been the catalyst for initiating the dispute, the district health board is required to act responsibly with public funding.

There is only a limited funding pool for rural funding.  It is simply not fair to general practices who meet the criteria for rural funding to see practices who do not meet this criteria receive a share of the funding. 

Second, the district health board did not withdraw the after-hours service. It was withdrawn by the GPs.

Third, the debate has not been about clinical safety. The GPs are prepared to provide 24 * 7 services for Temuka and Geraldine, but only if the district health board is prepared to negotiate funding outside of the national parameters - a principle the district health board is not able to entertain. 

Funding for general practice is largely set on the basis of national formulas. The GPs are free to work through their representative groups to attempt to influence national funding.  For its part, the district health board needs to be aware of the needs of the whole community it serves. 

Changes to any health services are always challenging, particularly where it means that local services are affected.  We continue to want to ensure that people throughout South Canterbury are able to access appropriate health services.  We need to focus on ensuring that services are sustainable, and this may require changes to the way they are being provided.

While the mediation process takes place, patients in Temuka and Geraldine can continue to use the current after-hours arrangements available to them. These are:

In an emergency dial 111 for an ambulance. If it is not an emergency, either dial your GP's number or the After Hours GP Line on 03 684 8209. In both cases you will be put through to a registered nurse who will direct you to the appropriate care, including access to the after-hours GP in Timaru if necessary.    Dr Moginie at Four Peak Health is still providing after-hours services in Geraldine.

In addition, the DHB has negotiated with Timaru Taxi's to provide a once-a-day shuttle from Geraldine and Temuka to the Dee Street after-hours clinic. The shuttle will return after the patients have been seen.

This will be for those who need to access to a GP in Timaru at the weekend, or during a public holiday, and cannot transport themselves.

A trial period for the new shuttle will start on October 1. Details of the timing and pick up points in Geraldine and Temuka will be announced next week. 

We appreciate that this does not solve the issues, however it does provide a further option for those needing weekend access to a GP.

Thank you for your time.