Conclusion
Use of the role delineation model for assessing hospital services is only one of the tools used in determining the future shape of rural health services. Performance monitoring of CHEs is also influencing the configuration of service delivery by putting pressure on CHEs to perform.
In the main, the provision of rural services will be determined by the decisions of the RHAs as to what health services they will be purchasing, and what conditions will be placed on those purchases through funding agreements and policy guidelines.
On safety, equity and efficiency grounds, there is a clear trend towards a greater centralisation of higher level surgical services in New Zealand. This will have to be accepted and accommodated. But it also offers opportunities.
It will be important to ensure effective ambulance services and targeted financial assistance for travel and accommodation costs so that rural residents are not disadvantaged in terms of access. But it is also important to realise that quality is an important aspect of access. There is no point in fighting to preserve local surgical services on historic grounds, when such services may not be appropriate, and may in fact be interfering with better provision of other health services which the community really needs.
In order for rural hospitals to prosper and continue to serve their local communities, they will need to reassess what services they offer. While higher level surgical services may be lost in smaller hospitals, greater emphasis on day surgery and on long term or recovery care may provide scope for maintaining a high level of services.
Contact for Enquiries
Rural Affairs Coordinator
Sector Performance Policy
MAF Policy
Ministry of Agriculture and Forestry
PO Box 2526
Wellington
NEW ZEALAND
Phone: +64 4 894 0675
Fax: +64 4 4 894 0745
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