Kerre Woodham: The ward for people with nowhere to go shouldn't exist, but I can see why it does

I was struck by a story from Radio New Zealand.  

North Shore Hospital, it has revealed, has an entire ward of people who are stuck in hospital, but they have no medical reason to be there. The 20-bed ward was created in May for patients who were effectively medically discharged but didn't have anywhere to go, such as an aged care facility.  

This shouldn't be happening. The chain of healthcare should include post hospital stay. But, as we know, there's been a hold up. There's been a clogging in the system when it comes to releasing people from hospital. Good on North Shore Hospital for setting up this ward where they’re not in the direct care of doctors but are looked after by nurses and allied health staff, such as physiotherapists and social workers and some of them are there for weeks.   

And this is the chain of care that I remember Dr Shane Reti talking about when he was health minister. He said we needed to ensure that GPs are properly funded so people don't end up in emergency departments because they can't access a GP - or they can't afford a GP.  

Then you need to receive operations in a timely manner, you need to receive the hospital care you need as expeditiously as possible, then you need to be discharged. If you no longer require hospital care, then out you go and the health workers along the chain will look after you there. The physiotherapists, the at home nurses, that sort of thing.  

If any one of these stages along the health care journey becomes congested, then that impacts the whole healthcare system. All parts of the healthcare system become affected. 

 So I think, in the absence of anywhere for these people to go, this ward makes sense. Deborah Powell, who represents allied health care workers, says it's not ideal. But, it is a good, practical decision to have them in one place rather than dotted around the hospital.  

She said it would be better to have them in the community, but we don't have that capacity right now. And the reason it's better to be out in the community was explained by the head of the senior doctors union, Sarah Dalton. She said you are much better off to be in the community where you can get dressed, you're out of the hospital gown, you're walking around, you're doing your daily things, you're doing exercise, you're getting fresh air. You're getting rehab.  

All of these are good and all of these will help for a faster healing, which is quite true. So, what do you do if you have a parent who's in a retirement village and they've bought one of the villas or the apartments where they're independent living, they're perfectly fine when they buy it. Absolutely dandy. Love their new life, living their best life, and then all of a sudden, they get ill and they have to have hospital care. Where do they go when they come out?  

It's exactly that kind of congestion that Shane Reti, and I'm sure other health ministers, have talked about before.  It's all interoperable, we need to take responsibility for our health. When things happen or if we're going through a bad patch or need health care we need to be able to see a GP. If we can't afford to or we can't get access to one in a timely fashion you went to the hospital system.  

Everything needs to flow smoothly from there. You're in that hospital bed. You get the treatment you need. You're out of that hospital bed and into community care. You can see what happens at any point if that gets congested. The whole system is under strain. How do we fix it? 

 

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