SDHB boss unaware of new Wanaka maternity hub

Southern DHB CEO Chris Fleming was unaware that his own organisation took possession of a new maternity hub location in Wanaka on June 4th.

The SDHB's floor plan for the maternity hub at 21A Gordon Street.

In a media release today the SDHB revealed that it took possession on June 4th of a property at 21A Gordon Road in Wanaka (see main image) that is to be the site of a long overdue Wanaka Maternity Hub.

However, when Crux asked on June 10th for Mr Fleming's comment on our original story about a baby being born early last Thursday morning on the floor of midwife Deb Harvey's office, next to the Wanaka Lakes Medical Centre at 23 Cardrona Valley Road, he sent us the following response.

"I have asked my team to provide me something and will come back to you.  My understanding is that Deb Harvey practices out of the Wanaka Lakes Medical Centre which is the location of the Hub which has the emergency equipment, resuscitaire, ctg,  drugs etc.  I trust that the heading “Wanaka Baby Born in Midwives Office” is a misrepresentation that you will correct.  If my information is correct then the baby was born in the hub which was precisely the reason for ensuring there is appropriate equipment, previously this was not available in Wanaka at all, and entirely dependent on whatever the midwife had in her car.

Chris Fleming"

In light of what we now know, Mr Fleming's email to Crux seems to illustrate a significant lack of knowledge about both the birth last week and the siting of his own SDHB maternity hub in Gordon Road.

Crux is also attempting to understand why news of the hub premises being secured on June 4th has not been revealed by the SDHB until today - eight days later.

Here's today's media release - followed by a copy of a statement from Mr Fleming. Neither the media release nor Mr Fleming's statement were initially supplied to Crux for reasons we are currently investigating.

 SDHB Media Release - June 12.

The creation of a permanent maternal and child hub supporting Wanaka LMC midwives and women in their care is a significant step closer with the announcement of the location of the future facility.

Southern DHB has signed a lease for the ground floor space at 21E Gordon Rd, off Ballantyne Road, taking possession on 04 June. 

The Wanaka facility will be the first custom-created space for a maternal and child hub In Southern’s integrated primary system of care and is expected to be operational in the early part of next year. The proposed layout of the hub can be viewed here.

“We are very pleased to have secured an appropriate space where LMC midwives can more comprehensively provide care to new and expectant mothers in Wanaka,” says Lisa Gestro, Executive Director, Strategy, Primary and Community, Southern DHB.

“As we know, the Wanaka property market is particularly challenging, but we’ve stayed focused on finding the right space in the right location and the building we’ve chosen is suitable for the hub and gives us options for the future.” 

The approximately 90m2 space will be completely refitted and is expected to include two, dedicated clinic rooms, an urgent treatment space, a lounge with kitchenette, equipment for telehealth consultations, plus supplies and medications for routine and urgent maternity care.

The emergency treatment space will be capable of accommodating rapidly progressing labours and births.

Other potential services – such as a weekly, midwifery drop-in clinic to connect women with local services and provide additional midwifery checks for women with complex pregnancies, as well as peer breastfeeding and parenting support groups, and antenatal and parenting education – could also be delivered from the premises in the future.

“It’s exciting to be able to custom create this space for a maternal and child hub and we‘ll work with the community to ensure it meets the needs of LMC midwives and of women who will attend clinics there,” Mrs Gestro says.

While the hub is developed, maternal and child services will continue to be provided from the space leased by Southern DHB at the Wanaka Lakes Health Centre (WLHC). 

The monthly telehealth clinics, also run from the health centre, have proven popular as well with more than 30 women taking up an obstetrics telehealth consultation since it began in October. 

While a current lack of additional space means the permanent maternal and child hub could not be co-located at the medical centre, Wanaka Medical’s Dr Andrew McLeod says hub services – including urgent care – will continue from the WLHC building in the interim.

“We will continue to work together to enhance primary maternity services in the Wanaka area, ensuring women and their babies are safe and well cared for,” he says.

Media statement from Chris Fleming, CEO, Southern DHB

Firstly, there is a maternal and child hub set up and running in Wanaka. In the interim, this is housed within the Wanaka Lakes Health Centre. It includes a clinic room, where consultations are held, plus access to emergency equipment is the emergency equipment including a resuscitaire and continuous foetal monitoring (CTG).  The CTG was brought to the clinic room to support the rapidly progressing birth there. There is also access through the after-hours service to the emergency triage space when needed. 

SDHB CEO Chris Fleming

The DHB is paying for all the costs associated with this. This has been set up late 2018 and is well utilised by the midwives.

This interim hub is a first step, to enhance support for the midwives who were working there.

Longer term we are moving to a facility in Gordon Rd, which we are fitting out for this purpose. It will be better configured for delivering primary maternity care, including two clinic rooms, and an emergency treatment room appropriate for birth if needed.

Prior to the implementation of the Integrated Primary Maternity System of Care, the midwives would only have had access to their own equipment.

The Save our Midwives group has been campaigning for a primary birthing unit in Wanaka.

However, it is clear that a primary birthing unit would not have been recommended in this situation as women with previous history of Caesarean section are advised to birth in hospital (not a primary maternity facility) due to additional risks of subsequent births. Any births anticipated to require access to specialist care, epidurals, assistance such as forceps, blood transfusions, or access to a theatre such as for a Caesarean section are recommended to occur in secondary unit in Dunedin or Invercargill.

It is not feasible to establish a 24/7 secondary care hospital in Wanaka, with the required roster of four general surgeons, anaesthetists, obstetricians, midwives, plus any other services that would be deemed necessary.

This is why access to secondary care for those living at some distance from these services depends on forward planning between the woman and her midwife, supported by emergency services – including PRIME responders and transport services, and the emergency equipment available at the interim hub - that can assist when things do not go according to plan.

The LMC midwife has made clinical decisions in response to the situation she was faced with, and we acknowledge her skill in managing a rapidly evolving situation and ensure the safe birth and care of the mother and baby. We congratulate the family on their new arrival."

Read: Baby born on floor of midwife's office.