Needle exchange handover concerns
DISC Trust has lost its contract to administer the programme, which will now be run by Christchurch-based health services provider He Waka Tapu.
He Waka Tapu is due to take over the service at the end of next month, but workers from the Dunedin branch of DISC trust said aside from a "heavily mediated meeting" nearly a month ago, there had been no formal contact about the handover of services.
Dunedin worker Gilbert May said the whole situation was worrying.
"It looks like a disaster is beginning to unfold. There's been radio silence."
His concerns were that the model proposed by the new provider did not allow for anonymity or necessarily a peer-support system.
It also had no prior experience in needle exchange.
"Clients are actively talking about having to run their own illegal distribution."
He and other group members want to meet Mental Health Minister Matt Doocey about the matter, not least because they predicted their roles would be terminated and the new programme would not be running on time.
"We want to make sure he knows that any deaths and other harms resulting from the poor decision and botched process are on his head."
DISC trust harm reduction lead Jason George did not want to comment on the new provider, but said "the main concern is for our clients, who have not had a voice in this matter".
University of Otago department of general practice and rural health Dr Geoff Noller said running a needle exchange was complicated.
"The provision of needle exchange services is a unique sort of service by definition of what it is. You're either injecting or you're not.
This could be an issue if the service moves away from peer support and harm reduction to a focus of a "recovery journey", he said.
"Harm reduction is at its core very much about the idea of human rights, and about people being met where they are, and not pressuring them to change, but supporting them to be as safe as they can.
"A risk that the new provider is going to have is that, are there staff who are in recovery and how are they going to manage having these conversations with people who basically want some equipment so they can go home and shoot up?"
Another major issue was the fact the funding model for the service shifted from needs-based to population-based.
"There's a higher prevalence of injecting in the South Island than there is in the North Island, and so you've had this shift in funding and the South Island has lost 30% of its funds.
"Somehow a new provider that doesn't have a footprint in needle exchange, and doesn't have a philosophy of harm reduction, is going to provide the service operating on 30% less funds."
He Waka Tapu and Mr Doocey diverted questions to Health New Zealand.
Health New Zealand starting well director Deborah Woodley said Health NZ was supporting the transition of services to the new provider.
matthew.littlewood@odt.co.nz
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