Heart patients worse off in Northland than Auckland: Specialist
health Northland 26 minutes ago
A leading Northland cardiologist says his patients are much sicker than they would be if they lived in Auckland. Ruth Hill reports.
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Expanded Lower Hutt medical centre to cater for 'daylight hours'
The Lower Hutt After Hours Medical Centre will move to the former Te Awakairangi Birthing Centre at the end of July. Photo: RNZ / Ruth Hill A former birthing centre in Lower Hutt, which was controversially mothballed four years ago due to lack of funding, will house an expanded after-hours medical service. Lower Hutt After-Hours Medical Centre - the only drop-in clinic for more than 100,000 Hutt Valley residents - is often forced to close its doors early to new patients, because it is unable to see everyone before 10pm closing time. Manager Mark O'Connor said the shift to new premises at the former Te Awakairangi Birthing Centre at the end of July would help alleviate some of the pressure. "The new clinic has 10 consultancy rooms, instead of the three-and-a-half we have now, and its waiting room is triple the size," he said. "Patients may still have to wait, but at least they won't be queuing in the wind and the rain, as they are now sometimes." The centre had also received Government funding to extend its opening hours to "daylight hours" during the week. Currently, its hours are limited to 5.30-10pm, Monday to Friday, and 8-10pm on weekends and public holidays. From late this year or early next year, it was planned to open from 8am every day. "Until now, Hutt Valley has been the only metropolitan area without daytime urgent care, so that's a big change," he said. "We never had the facility before here. "If you know our old building, we would never have been able to cope with that during the day, but with this new facility, it gives us that opportunity. We just have to resource it." Recruitment of additional staff could be a challenge, but the attraction of a new clinic would help with that. Lower Hutt After Hours Medical Centre is leaving its current cramped premises next month. Photo: RNZ / Ruth Hill "We need to close at 10pm, because most of my doctors are working at practices during the day, so we can't keep them too long." The new clinic was also upstairs from a radiology centre, which meant patients with suspected fractures would no longer need to go to Hutt Hospital's emergency department. Frustrated patients have taken to social media to complain about the clinic closing early. One woman - who was turned away last Friday, after trying to get an appointment with her own GP all week - said the doctor shortage was the biggest barrier. "If they can fit more people into the premises, but they don't have more doctors to do the hours, then they're going to have the same problems." A plan to turn the old Te Awakairangi Birthing Centre into a special care unit was developed when Labour was in power and was heavily supported by then-MP Chris Bishop. The birthing centre, which was owned by a charitable trust, closed in 2021. Te Whatu Ora took over the facility and planned to open a first-of-its-kind transitional care unit for sick babies in 2023, but this never happened. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
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Twelve-month prescription renewals: What you need to know
The government's plan will allow some patients to go longer between prescription renewals. Photo: 123RF In the annual flood of Budget coverage a few weeks back, one of the big announcements for the health sector was a move to allow 12-month prescription renewals from 2026. But how is it going to work and how will it affect your health services? RNZ is here to explain it all. The current maximum prescription length for most medicines is three months, but the government's new plan would extend that to 12 months for many medicines. This means that some patients will no longer need to visit their GP every three months to get their standing medication renewed. While some repeat prescriptions can be filled without a doctor's visit now by contacting their office, guidelines by the Medical Council of New Zealand on good prescribing practice say "patients receiving repeat prescriptions should be assessed in person on a regular basis" and repeats are given only with a doctor's discretion. In announcing the plan , Health Minister Simeon Brown said the current system "creates unnecessary barriers for patients on stable, long-term medications like asthma inhalers, insulin for diabetes, and blood pressure tablets. It means added costs for patients and more paperwork for health professionals, taking time away from patients with more urgent or complex needs". Medicines will still have to be dispensed every three months from pharmacies. "It's a win-win for patients and the health system - fewer avoidable hospitalisations, better health outcomes and reduced long term costs," Brown has said. Not until the first quarter of 2026. Luke Bradford of the Royal New Zealand College of GPs. Photo: supplied This is expected to mostly affect people on long-term medicines, the Ministry of Health said. The increased prescribing limit will also apply to oral contraceptives, which currently have a six-month prescribing limit. Royal New Zealand College of GPs medical director Dr Luke Bradford said that during consultation on the plan, the college had supported a six-month prescription renewal instead of 12. "We submitted on this and said 12 months is probably too long, six months would be reasonable." Dr Bradford said there would not be a centralised list of drugs that are part of the scheme and physicians will need to determine who benefits from 12-month renewals. "It's very much going to be a patient by patient situation and we can't put blanket rules across this. It depends on a whole raft of things but predominantly depends on conditions being managed." If you have multiple prescriptions for multiple conditions, you are far less likely to get 12-month renewals as a physician needs to monitor your ongoing health and possible interactions. "Prescribers will be responsible for determining the clinically appropriate prescription length and can prescribe for up to 12 months, or for shorter periods if they consider that most appropriate," a spokesperson for the Ministry of Health said. Controlled substances - which include opiates such as morphine and fentanyl - are not included. Controlled substances will not be included. Photo: 123RF/Steve Heap 2016 The Budget allocated $91 million over four years "to support this change". "It is expected this change will increase patients' access to medicines and therefore create a higher demand for medicines. Funding is required for the Combined Pharmaceutical Budget to meet the increased demand for medicines," the Ministry of Health spokesperson said. "The Budget includes $10m initial funding in the 2025/26 financial year, with outyear funding held in contingency, pending information gathered from the initial uptake." Some patients won't have to go to the GP quite as often, in theory. GP visits are charged differently from place to place and can run anywhere from $20 to $90 depending on the complicated calculation of fees at individual doctors' offices. The Ministry of Health has said that the average patient who renews prescriptions four times a year could save up to $105 a year on GP fees. It also has said the change could mean less time off work or school for appointments and it could make life easier for people in rural and remote areas who travel to get to their doctor. No. The $5 co-payment for most prescriptions - which was brought back under the current National-led government - will remain unchanged. And you'll still need to go back to the pharmacy every three months to have your prescriptions dispensed even if you're on a 12-month renewal from your doctor, Dr Bradford said. "There's some safety mechanisms built into this in that they're not going to dispense 12 months of medicines. People aren't going to suddenly have huge boxes of medicine at home." In a statement to RNZ, the Pharmaceutical Society of New Zealand said it cautiously supported the move, but had concerns. "PSNZ support the increased period in principle, but with some provisos - as always, it's the detail that will matter and we are waiting to receive that. "For example, there is currently no indication that funds to support the extra monitoring and counselling that may be required, when patients are picking up their medication every three months without any interacting with their general practice." If people visit their GPs less often, it will affect the income their practices receive. In its submission on the proposal , the Royal College said prescriptions account for between seven to 10 percent of practice revenue. "The financial impact on practices that rely on revenue from current prescription renewals could be substantial, e.g., one specialist GP calculated a $320,000 loss in a patient population of 14,500," that submission also reported. "There will definitely be an impact on that," Dr Bradford said. At the same time, it won't necessarily reduce the admin work needed. Doctors will still need to do the legwork with their patients to keep on top of ongoing records, tests and screening, he said. Health Minister Simeon Brown. Photo: RNZ / Nick Monro On its website, the Ministry of Health said the Medicines Regulations will need to be amended to increase the maximum length of prescriptions, and IT systems will need to be updated to allow this change. The Medicines Regulations 1984 will need to be amended. Pharmac will make changes to the Pharmaceutical Schedule, while Health NZ will work to support GPs, other prescribers and pharmacies with updating systems and the transition. The Pharmaceutical Society said it also would work to ensure the prescription plan changes go smoothly. "PSNZ will use this time to engage with officials to support a smooth transition and highlight any unintended consequences, particularly any changes in workload and financial pressures that this change could place on pharmacists and their teams," it said in its statement. General Practice Owners Association chair Dr Angus Chambers recently told RNZ that many patients with chronic conditions needed regular reviews by a doctor or nurse. "Just to leave someone for 12 months to have their diabetes deteriorate may well lead to more emergency department visits and hospital admissions." Everyone manages their conditions differently, Dr Bradford said, and no two cases are quite the same. "If you're on five different meds for diabetes you're going to need three-month checkups." In announcing the plan, Simeon Brown said it would give GPs a breather. "Instead of spending time on routine repeat prescriptions, they can focus more on supporting those with complex or deteriorating health needs." Dr Bradford said the current three-month renewals do give a "safety net" for physicians to keep on top of issues. "By taking that away we either say we've still got to do that or the pressure goes on GPs to do it anyway and have to sit their own reminders for those periods of time and follow it up in their hour of clinic time." "The majority of patients will be fine," but a visit to a GP involves a lot more than just checking off a prescription renewal box, Dr Bradford said. "The moment you come in we're watching how you're walking, we're looking at your body language and listening for cues and we're reminding you of the screening you haven't done. "Those things that happen because you come in and say, 'Oh, I'm just here for my asthma medicine, doc,' are at risk of being lost." Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
