Saturday, 04 July 2020


Funding issues blamed for ambulance delays on the Coromandel

“Constrained resources” is the reason for at times lengthy delays in responding to emergencies on the Coromandel Peninsula.

St John Territory Manager for East Coromandel, Rosanne Shaw, also highlighted the increasing volume of calls local crews are having to respond to, particularly in the past 12 months, but said no further ambulances could be staffed as funding was not available.

Roseanne was responding to queries about the level of cover available on the Peninsula after one recent incident saw a Whitianga man, who believed he was having a heart attack, wait 90 minutes for help to arrive. While advice was provided by a paramedic via phone, the man was eventually airlifted to Auckland City Hospital by the Auckland and Coromandel Rescue Helicopter after the nearest available ambulance had to travel from Paeroa.

“St John takes patient safety and care very seriously,” Rosanne said. “Our emergency ambulances operate as a network and the closest ambulance may not be at the local ambulance station.”

Currently the Coromandel is served by seven ambulances with one staffed vehicle based in Whitianga, Coromandel Town, Tairua, Thames, Ngatea, Whangamata and Paeroa. However, only three of these operate at night - Whitianga, Thames and Paeroa - and neither Coromandel, Tairua or Ngatea run at weekends. St John said there are also “several volunteer-crewed First Response Units in the area,” but did not clarify where these are based or what hours of service they cover. It is understood that the volunteer units do not have a paramedic on board.

A nationwide transition to double crewing - which will require all ambulances to have two personnel - is also having an impact on resources. “We are currently reviewing the whole of the Coromandel as part of [our] Double Crewing project, noting St John’s goal is that all ambulances in the area will become double-crewed by June 2021,” said Rosanne.

Describing the circumstances around the 90-minute wait experienced after a recent call to 111, Roseanne said, “St John triages all 111 calls to determine the urgency of the patient’s condition. We aim to send the most appropriate ambulance to the patient in greatest need as soon as possible.   Unfortunately, in the Whitianga incident you refer to, all available road ambulances in the immediate vicinity were already committed to other life threatening situations and unable to immediately respond. 

“Due to the serious nature of the patient’s condition and the lack of availability of a road ambulance within a reasonable distance, an air ambulance was dispatched to transport the patient to Auckland Hospital. The helicopter and a road ambulance from Paeroa were dispatched at the same time, but it takes time to prepare a helicopter for a night flight and landing. The road response distance from Paeroa was below the level of service we would like to provide, but it was unavoidable in this case.”

On the night in question, the initial call to 111 was made by the patient’s wife at around midnight when he experienced shortness of breath and pain down his arm. According to the flight records for the Auckland and Coromandel Rescue Helicopter, the helicopter crew was dispatched at 1:15am. With no-one in attendance at the couple’s home, the man drove himself to the airfield to meet the helicopter where he was assessed as being in a serious condition, although the pain was later determined to have not been the result of a heart attack. He has since been discharged.

“Best efforts were made to get care to this patient,” Rosanne said. “As the road ambulance was still some time away when the helicopter landed at the Whitianga Airfield, the Clinical Support Officer made inquiries as to  whether the patient’s family members were able to transport the patient from the scene to the Whitianga Airfield, which is approximately a five-minute car journey. Clinicians have to make decisions balancing the risk of time delay or ambulance transportation and while it is not common, occasionally they may request self-transportation to an airfield as the fastest and safest option. The decision to utilise private transport in this instance has been reviewed by our Medical Director, who has confirmed that it was the most appropriate and safest option in that setting.”

The Informer has confirmed that an after-hours doctor was available on the night, however, it is unclear why they were not alerted. The Whitianga Volunteer Fire Brigade, who frequently respond to medical situations if an ambulance is not available, was also not contacted and was only mobilised to provide a safe landing zone for the helicopter.

With negotiations underway in relation to a new ambulance service contract from the government, St John says it is unable to make any promises in relation to increasing funding for the Coromandel in order to relieve pressure on current staff and volunteers, who continue to provide an excellent level of care in the face of an ever-increasing demand.

“Response time, particularly to calls triaged as non-urgent, has increased over the last 12 months, reflecting both the increase in demand for ambulance services and our constrained resources,” said Rosanne. “St John is in discussions with the Ministry of Health and ACC to develop a more sustainable future funding model to meet the New Zealand public’s needs and expectations.  We have put in a request for additional funding to government and await outcomes in this year’s May budget.

“Given our current funding position, there are no immediate plans to add paid ambulance resources on the Coromandel, however we recognise the need for more resources and we continue to support our local volunteer team to attract and recruit volunteers to provide greater resilience in the area.”

While St John makes its case for more funding, Health Minister, David Clark, said money is no excuse for an inadequate service. “My clear expectation of our health services is that the significant increase in health funding in this government’s first two budgets should be used to ensure timely medical care for all New Zealanders no matter where in the country they are,” he said. “Now they have the additional resources, it is up to local health authorities in each area to ensure this happens.”

The recent incident referred to in this article, where a Whitianga man who believed he was having a heart attack had to wait 90 minutes for help to arrive, reinforces the need for a discussion abouta rescue helicopter on the Coromandel Peninsula. The petition currently on foot - calling on the government to reinstate a rescue helicopter based in Whitianga, at least over the busy holiday periods - has already attracted more than 38,000 signatures. Hard copies of the petition are available around the Coromandel. The petition can also be signed online, simply google “Coromandel rescue helicopter petition.” The petition will remain open until 30 April.


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