Health plays down doctor issue

Friday January 27, 2017 Written by Published in Health

The LACK of doctors in the outer islands is not making a negative impact on residents’ health, says Health ministry secretary Elizabeth Iro.


She was commenting on a shortage of doctors which has seen all of the doctors in the outer islands apart from Aitutaki replaced by nurses and “nurse practitioners” -  registered nurses with midwifery qualifications.

Iro says the nurse practitioners have been trained in an advanced programme and are able to diagnose and treat many conditions.

“The positive comments already from specialists who have seen patients previously managed by these nurse practitioners has been an indication of their professionalism.”

Asked if the lack of doctors the outer islands was because of the Health ministry’s budget of just $2.2 million, Iro said recruitment of both doctors and nurses had been “challenging” for many years.

“The shortage of health professionals is not a new regional and international problem. Increasing the budget would allow us to attract the doctors with better recruitment packages and to be more competitive in the marketplace. 

“Our uptake to medical school has always been low, with usually just one graduate every second or third year in the undergraduate programme. We have four in training at the moment.

“I have been pushing for at least a 5 per cent of GDP for health budget. Currently it is 3.4 per cent of GDP.

The budget was “never enough”, Iro said.

“So we have to manage within the resources and hence have looked into levels of care and the right skill sets of professionals.”

A source who asked not to be named last week told CI News official figures showed the outer islands had higher rates of deaths in the under-five age group compared to Rarotonga.

“Despite these disparities, due to budget constraints a number of health services were cut in 2011, including reducing the hours of health services on some outer islands to 9am-1pm.

“Four health positions in the outer islands (one dentist and three nurses) were also not refilled.” Asked whether the lack of doctors could be putting resident’s lives at risk, Iro said early identification of high risk cases on the outer islands were always discussed “very early” with relevant specialists on Rarotonga including surgeons, general physicians, obstetricians, and paediatricians.

“Many cases have been able to avoid transfer to Rarotonga because of early intervention and excellent treatment and management plans handled early through this model of care.

“The emergency cases transferred are stabilised by the nurse practitioners, again in consultation with the relevant doctors at the Rarotonga hospital.”

Iro said the fact that the country was able to maintain a low infant (under five years) and zero maternal mortality rate was a good indicator of the good standard of health care in the Cook Islands.

“The last maternal death was in 1995. No case has been brought to my attention that I can recall that was the result of a medical staff endangering lives.

“I have, however, had a couple of cases brought to my attention when the patients refused to take their medications and (follow) medical advice and later needed to be evacuated to Rarotonga.”

Meanwhile, a Radio NZ report says people of Mangaia are worried about the loss of their only doctor, who has resigned for reasons Iro was unable to clarify. The doctor will be replaced by a nurse practitioner

Mangaia Tere Atariki said everyone on the island was concerned the resident doctor had left. He said the population of about 460 was made up of mainly old and young people who need health care.

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