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Tairawhiti DHB pulls pin on GPs in schools

A GP who provided care to students at three Gisborne high schools is concerned young people could come to harm now the DHB has pulled funding for the service.

Free GP appointments at Gisborne Boys', Gisborne Girls' and Lytton high schools have come to an end as Hauora Tairawhiti looks to rejig funded youth health services in the region.

The redesigned services are still to be determined, but the DHB canned the in-school GP service contract at the end of last year.

That means the 2000 students who previously had free access to a GP at school will need to visit a medical centre and potentially pay for a doctor's appointment.

De Lautour Medical GP Liza Fairbairn, who has helped provide the clinics since 2016, said students' mental health challenges were often uncovered during consultations.

There was a risk students previously supported by the service could come to harm without something to replace the in-school clinics, Dr Fairbairn said.

“This isn't just about people who can't afford to take their children to the doctor,” she said. “This is about young people who don't even have anyone looking out for them.

“To me, that was the real role these clinics played — educating students about how to access healthcare for themselves.”

A GP would visit each school up to three times a week, seeing on average 100 students a month. Up to 70 percent of those students were Maori.

Gisborne Boys' High School principal Andrew Turner is “hugely disappointed” by the DHB's decision not to continue funding the service, which has been in place for about two decades.

The in-school GP clinics have been “invaluable”, said Mr Turner, who is concerned about the gap left in their wake.

“They were providing a service our young men wouldn't otherwise get access to,” he said.

The service had removed barriers to accessing a GP, including cost and transport, allowing young people to visit a doctor without their parents' involvement.

The DHB informed the schools late last year the contract would not be continued, Mr Turner said.

The service had been on borrowed time since the start of last year, when the DHB agreed to continue funding the clinics for six to 12 months while it worked on designing a new mix of youth health services to capture more of the district's young people.

Hauora Tairawhiti planning and funding manager Nicola Ehau said Gisborne's youth had been calling for more wide-ranging health services since 2008 when their views were outlined in a DHB youth health strategy.

“We need to let the youth of Tairawhiti know that we've heard them,” Ms Ehau said of the DHB's decision to stop funding the in-school GP clinics while it made “well overdue” changes to its youth health service offerings.

The DHB was still working on what its new mix of services would look like and Ms Ehau could not provide a time frame for when that design work would be completed.

The in-school GP service contract was no longer sustainable, given increasing costs for general practice services, Ms Ehau said.

She would not reveal how much the contract for the 2019 school year was worth.

It was also an inequity to have three schools with the service while others missed out, she said.

Dr Fairbairn agrees youth health services in the district need to be evenly spread, but she said taking away the free GP clinics from those who had them did not help young people at other schools who did not.

There were 9427 school students in Tairawhiti, including 2976 at high schools, as of July 1, 2019.

GP appointments are free for children aged under 14.

“I felt that at the very worst the DHB would have reduced the services to those three schools to increase services in other areas,” said Dr Fairbairn, who has offered to help the DHB develop its new youth health programme.

Mr Turner said the service appeared to tick all the boxes from the Ministry of Education's point of view, which is pushing for schools to be community hubs with a range of support services.

But it would appear the Ministry of Health, which funded DHBs, had a different kaupapa, he said.

Ms Ehau said funding for the in-school GP service contract would be reinvested in youth health services.

She warned that a general practice service may not be part of the DHB's redesigned youth health programme.

The DHB was increasingly being asked by the Government to improve the accessibility of healthcare to those who needed it most.

“They're not easy decisions to make, but at the end of the day that's our job.”

HUGELY DISAPPOINTED: Gisborne Boys' High School principal Andrew Turner says the in-school GP clinics 'were providing a service our young men wouldn't otherwise get access to'. File picture
CHANCE TO TALK: Dr Liza Fairbairn says students' mental health challenges were often uncovered during the school-based consultations. Picture by Aaron van Delden

  1. Vicky Henry, Hamilton, ex Gizzy girl says:

    OMG! Really, it shouldn’t always be about money. It should be about improving access, decreasing inequity, and healthy, well students who learn and engage better.
    Come on DHBs, look outside the box – put nurses back into schools if you can’t afford Drs #frustratedpublichealthnurse😡

  2. Leanne Bodle says:

    Disgusting decision DHB, taking away the “ambulance at the bottom of the cliff” and still wondering what to replace it with. Meanwhile our children and students will suffer. All for money. These clinics are invaluable for working parents, we don’t need to take hours off work to sit and wait at our own GP. Adolescents are learning to care for their own health, learning to make appointments and build relationships with other health professionals. They can access a Dr when they need it, instead of waiting for someone to take them. They can’t just walk out of school and walk to the town doctors, the convenience is just one factor. It all just doesn’t make sense.

  3. Leighton Hirst, UK says:

    Why is it that government service providers cut a facility before providing its replacement?
    This type of action looks suspiciously like a simple cost-saving exercise. The plan to create alternative resources for youth health services should be clearly defined before cutting the existing service. Once again, those who suffer most will be those with least opportunity to complain.

  4. Heni Waikawa says:

    On the other hand, I was shocked to discover the GP had issued my 15 yr old child with a drug without my permission, which led to side effects, which I had to deal with a month on. It wasn’t the prescribing I was against, it was the not knowing. Imagine if the child got so sick they couldn’t talk or explain to the hospital what was in her body, when the potential cause of symptoms is not known to parents or caregivers. I approached the school principal who had no idea this was happening to some of his students. At the time he was unaware that the GP was within their rights to prescribe a drug to a minor. Imagine if rogue doctors were prescribing illegal drugs to our children.

  5. Megan Kelso says:

    This is disgusting – just another “let’s put money before people”. It was good to know that young people had somewhere to go for medical care/advice if not feeling comfortable talking to parents – and if it saved one female from an abusive relationship, especially at that age, it was worth it.
    We keep talking about the ambulance at the bottom of the cliff – here was an opportunity to get that ambulance halfway up. But no, let’s pull the plug while we spend 12 months or more deciding what to do. Oh, and by the way DHB, when is something going to be done here to help local people with addiction problems, or has this money been diverted somewhere else like the school funding?

  6. Justin says:

    There is no security there for students now – not just for drugs, what if they get seriously injured during this time? Children/young adults will now have to suffer in pain waiting for someone to get an ambulance and not having a place to go.
    Young people are our future. They have free GP visits, yes, but that’s only if you have an appointment. I don’t feel happy sending my children to a school with no medical experts for injuries, seizures or any sort of thing – dumping it on teachers who have kids they can’t control while dealing with medical situations. This is not on. I moved here for a better life for my children and to have them somewhere where they are heard and looked after. Iwould rather home school now with this decision.