Opinion: Cromwell the place for new inland Otago hospital
At Thursday's public meeting in Wānaka, opposition leader Christopher Luxon hinted at an announcement about Dunedin Hospital, and wider hospital investment, from the National Party ready in the wings.
Well, good thinking Mr Luxon, but can I make some suggestions given the organisational mess that the Dunedin rebuild has become. That project does not need more complication.
Here is what could happen - Create a new hospital, say 150 beds in Cromwell, directly serving the big population of our inland city in Central Otago-Queenstown Lakes. At the same time leave the Dunedin Hospital rebuild alone.
The Dunedin City Council has campaigned for more beds, as has the Otago Daily Times. But do the beds need to be in Dunedin, given that Central Otago and Queenstown Lakes is where the growth is - already near 60 percent of the size of Dunedin. New hospital beds in Cromwell will be a big help to Dunedin - It's not competition.
Of course, the suggestion of any one site brings opposition. While the location will annoy some in Queenstown, Alexandra and Wānaka, a Cromwell hospital would be sited in the centre of the population. And serving the entire population is what it is all about. Most people would travel for 45 minutes or less, much as you would expect in Auckland.
It will annoy those with jobs at Frankton and Dunstan hospitals (50 beds combined) because those jobs will be in Cromwell. Health service staff often lead opposition to a change, opposition that does not come from the people. Justifiably staff get concerned for jobs and their role. The legally correct but antagonising employment practices encourage that resistance. It would be better to say to staff, “your future is protected and a role will be found but the scheme will be changing”.
But, overall, travel is reduced - the enhanced capacity of 150 beds at Cromwell means much less travel for specialised appointments and much less travel for people supporting family admitted into Dunedin Hospital. And it provides the extra beds being campaigned for.
A larger site for Central Otago-Queenstown Lakes advantages the people here. A larger hospital can justify more comprehensive staffing overnight. A larger hospital can accommodate variable demands more easily, with less staff stress. Locals can expect more specialised roles, a greater variety of equipment and functions. Smaller hospitals cannot provide these things.
It's not a contest, Dunedin remains a strong part of the service and co-ordination is vital. The new Dunedin Hospital will spend vast amounts to become digital, and extension of that system into Cromwell would be economical. Co-operation and integration could be that close.
We all know people who drive to Dunedin, perhaps stay overnight, for a mere 10-minute appointment. A local service can reduce that. Regular talk did not lead the former Southern District Health Board to embrace teleheath services and many people prefer the face to face anyway.
Let's not mention those 3,500 necessary but absent carparks at the new Dunedin Hospital - it will make it difficult for Dunedinites and a nightmare for those out of town. But, while we are not mentioning carparks, Cromwell has useful areas of flat land, whether that be building in the pine trees or on spare areas of the Cromwell Racecourse. Room to move, room to park, and importantly room to rebuild and adapt as hospitals do over the years. Think of a building like the current Dunstan Hospital - single story economic, elegant and practical.
It really is a big inland city in Otago. It's got a large and growing population likely to be greater than Dunedin in a few years. Central Otago and Queenstown Lakes is more spread out than Dunedin but with 75,000 people it's not so little and Dunedin with 130,000 people is not so big.
Actually Dunedin, with all those facilities, is only 1.7 times the size of our inland city. The current population of 75,000 counts. Indeed it deserves a reasonable hospital as the population will become 100,000 in the foreseeable future.
The Southern District Health Board is no more. With our new nationwide health service Central Otago and Queenstown Lakes would make a sensible area for one of the new “Localities”, which are to give voice to the local communities. A ”locality plan” will be devised. The plan would also define where hospital services should be found. It might say in part, Cromwell for some things, with Christchurch and Dunedin for more complex services and Auckland for the extremely specialised.
Watch as the locality thing develops, and contribute. It is a chance to end the harmful post code lottery we experience for hospital services. And look forward to to the new Cromwell Hospital.
Writer Kerry Hand worked in the southern mental health services as a registered nurse for many years, operating the successful Miramare agency, which provided him opportunity to closely observe money flows and operations in the sector. He maintains an interest in the allocation of health resources and the ways of structuring services to make them an easy, ordinary, resource for all people.