Kerre Woodham: The ward for people with nowhere to go shouldn't exist, but I can see why it does

I was struck by a story from Radio New Zealand.  

North Shore Hospital, it has revealed, has an entire ward of people who are stuck in hospital, but they have no medical reason to be there. The 20-bed ward was created in May for patients who were effectively medically discharged but didn't have anywhere to go, such as an aged care facility.  

This shouldn't be happening. The chain of healthcare should include post hospital stay. But, as we know, there's been a hold up. There's been a clogging in the system when it comes to releasing people from hospital. Good on North Shore Hospital for setting up this ward where they’re not in the direct care of doctors but are looked after by nurses and allied health staff, such as physiotherapists and social workers and some of them are there for weeks.   

And this is the chain of care that I remember Dr Shane Reti talking about when he was health minister. He said we needed to ensure that GPs are properly funded so people don't end up in emergency departments because they can't access a GP - or they can't afford a GP.  

Then you need to receive operations in a timely manner, you need to receive the hospital care you need as expeditiously as possible, then you need to be discharged. If you no longer require hospital care, then out you go and the health workers along the chain will look after you there. The physiotherapists, the at home nurses, that sort of thing.  

If any one of these stages along the health care journey becomes congested, then that impacts the whole healthcare system. All parts of the healthcare system become affected. 

 So I think, in the absence of anywhere for these people to go, this ward makes sense. Deborah Powell, who represents allied health care workers, says it's not ideal. But, it is a good, practical decision to have them in one place rather than dotted around the hospital.  

She said it would be better to have them in the community, but we don't have that capacity right now. And the reason it's better to be out in the community was explained by the head of the senior doctors union, Sarah Dalton. She said you are much better off to be in the community where you can get dressed, you're out of the hospital gown, you're walking around, you're doing your daily things, you're doing exercise, you're getting fresh air. You're getting rehab.  

All of these are good and all of these will help for a faster healing, which is quite true. So, what do you do if you have a parent who's in a retirement village and they've bought one of the villas or the apartments where they're independent living, they're perfectly fine when they buy it. Absolutely dandy. Love their new life, living their best life, and then all of a sudden, they get ill and they have to have hospital care. Where do they go when they come out?  

It's exactly that kind of congestion that Shane Reti, and I'm sure other health ministers, have talked about before.  It's all interoperable, we need to take responsibility for our health. When things happen or if we're going through a bad patch or need health care we need to be able to see a GP. If we can't afford to or we can't get access to one in a timely fashion you went to the hospital system.  

Everything needs to flow smoothly from there. You're in that hospital bed. You get the treatment you need. You're out of that hospital bed and into community care. You can see what happens at any point if that gets congested. The whole system is under strain. How do we fix it? 

 

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Episode Transcript

Speaker 1 (00:06):
You're listening to the carry Wood and Morning's podcast from
news Talks, he'd.

Speaker 2 (00:10):
Be struck by a story from Radio New Zealand. North
Shore Hospital, it has revealed, has an entire ward of
people who are stuck in hospital but they have no
medical reason to be there. The twenty bed ward was
created in May for patients who were effectively medically discharged

(00:32):
but didn't have anywhere to go, such as an aged
care facility. This makes sense, actually, I mean, it shouldn't
be happening that chain of healthcare should include post hospital stays.
But as we know, there's been a hold up, there's

(00:54):
been a clogging in the system when it comes to
releasing people from hospital. But it makes sense I think
for north Shore and good on them for setting up
this ward because they're not dot around different wards where
people need, you know, the care of doctors and nurses.
They're looked after by nurses and allied health staff such

(01:17):
as physiotherapists and social workers and they're all in one place,
so they get the kind of not hospital care, but
healthcare that they need in one place. Some of them, unfortunately,
are there for weeks. And as I say, this is
the chain of care I remember Shane reci doctor Shan
Ressi talking about it when he was Health Minister and

(01:40):
talking to Mike about what he saw were the issues
with the health system in New Zealand, and he said,
we needed to ensure that gps are properly funded so
people don't end up in emergency departments because they can't
access a GP or they can't afford a GP. Then

(02:03):
you need to receive operations in a timely manner. You
need to receive the hospital care you need as expeditiously
as possible. Then you need to be discharged. If you
no longer require hospital care, then out you go, and
the health workers along the chain will look after you. There,
the physiotherapists, the at home nurses, that sort of thing.

(02:26):
At any point, if any one of these stages along
the healthcare journey becomes congested, then that impacts on the
whole healthcare system. All parts of the healthcare system become affected.
So I think the wood is, you know, in the

(02:47):
absence of anywhere for these people to go. This makes sense.
Deborah Pale, who represents Allied Healthcare Workers, says it's not ideal,
but it is a good practical decision to have them
in one place rather than dotted around the hospital. She
said it would be better to have them in the
commute unity, but we don't have that capacity right now.

(03:09):
And the reason it's better about in the community was
explained by the head of the Senior Doctors Union, Sarah Dalton,
who said, you are much better off to be in
the community where you can get dressed. You know, you're
out of the hospital gown, you're walking around, you're doing
your daily things, you're doing exercise, you're getting fresh air,
you're getting rehab. All of these are good and all

(03:31):
of these will help for a faster healing, which is
quite true. So what do you do? What do you do? Say?
If you have a parent who's in a retirement village
and they've bought one of the villas or the apartments
where they're independent living, they're perfectly fine when they buy it,
absolutely dandy, love their new life, living their best life,

(03:52):
and then all of a sudden they get ill and
they have to have hospital care. Where do they go
when they come out? If you're an independent living, that's
what it is. You're an independent and seeing you're living
your best life. Under acc you might get visits from

(04:12):
a district health nurse. But where do you go? What
do you do if you don't have anywhere to go?
If you are living in a home where there are
too many people for too few beds, and you have
somebody that needs the sort of care and attention that

(04:38):
needs to be done in the community, higher level care
than just living on your own. But they don't need
to be in hospital, but they do need some level
of care and attention, and you simply can't provide for that.
Have you come up against this before, if you're working
in the healthcare system, or if you are somebody with

(04:59):
a family member who doesn't need to be in hospital
but certainly needs a level of care that you can't
fight in the community. It's exactly that kind of congestion
that Shane Retti was and I'm sure other health ministers
have done so before, have talked about this before. It's
all interoperable all of the states. We need to take

(05:19):
responsibility for our health when things happen or if we're
going through a bad patch or whatever and we need healthcare.
We need to be able to see a GP if
we can't afford to or we can't get access to
one in a timely fashion. You enter the hospital system,

(05:42):
and then everything needs to flow smoothly from there. You're
in that hospital bed, you get the treatment you need,
you're out of that hospital bed and into community care.
You can see what happens at any point if that
gets congested. The whole system is understrained. How do we
fix it?

Speaker 1 (06:02):
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