A leading midwife has welcomed more youth funding for Māori health providers but warns the changes are a 'sticking plaster on a huge gaping festering wound'.
Hawke's Bay's District Health Board has revealed that a new youth health collective, Te Kahui Waiora, which has a kaupapa Māori foundation, is in a transitional period with full services operational by July 1.
The collective offers free healthcare services to under 24-year-olds, and supersedes free healthcare on offer through some general practices in Hawke's Bay for under 18-year-olds.
Some GP practices will continue to fund their own free healthcare for youth.
Across five providers, Te Kahui Wairoa offers:
- Free access to services that provide sexual health, mental health and addictions and basic youth healthcare and treatment for under 24s.
- Free access to a general practitioner or nurse practitioner as required by rangatahi.
- Free prescriptions for under 24s.
The range of services is available across the providers with some specialising in areas such as sexual health.
Leading midwife Jean Te Huia told Hawke's Bay Today the funding was a positive move for Māori health providers who had been offering the services without DHB money.
However, Te Huia also warned it was a ''sticking plaster on a huge gaping festering wound''.
The health system was experiencing a crisis with one of the biggest issues being the GP shortage.
Te Kahui Wairoa will now enable young mothers in transitional housing to access vital health services.
Transitional housing tenants/clients are considered 'of no fixed abode' and cannot enrol with GPs.
Huia told Hawke's Bay Today the new access to free healthcare was especially important as, in her view, most of the country's sexual and reproductive healthcare is 'tied up with GP's' during a national GP shortage.
"For many many years, some GP practices have been receiving HBDHB funding to provide free sexual health to under 24-year-olds.
"(There are) only 4800 GPs nationwide - that's one per every 100,000 people.''
Te Huia said the irony was there was an existing health workforce of "68,000 nurses, 345 nurse practitioners and 3400 midwives - all clinically capable of providing contraception and sexual health to women in NZ''.
However, the health system did not easily allow the devolution of clinical care to a ''professional team of nurses and midwives'', she said.
Te Huia said it was 'ridiculous' that a midwife could start a woman on contraception, but had to end involvement six weeks after the birth of the child, under current midwifery practice rules.
The Midwifery Council of NZ is currently undertaking a review of midwifery practice, and Emma Foster, executive director of planning and funding, says the DHB will welcome the review findings.
Foster also says the DHB is looking forward to seeing GPs work alongside new youth health providers ''to better meet the needs of rangatahi of our rohe''.
The change comes after regular reviews of the DHB's policy of providing free healthcare for under-18s through selected GPs, which started in 2016.
There was initial demand from Māori and Pasifika patients in areas of low deprivation, and the policy was extended to other practices.
However, demand decreased, and a need for a ''co-design of health services, to better meet the growing needs of our rangatahi Māori and Pasifika population'' was identified.
Te Huia said in her view, "the GPs' power over health services has crippled healthcare, and resulted in the lack of access for poor, mostly brown people".