By Turanganui PHO Chief Executive Keriana Brooking

A colleague asked me the other day if Turanganui Primary Health Organisation is in a better place now, than it was at the start of 2009. It’s the million dollar question for any leader and as the year draws to a close All Blacks coach Graham Henry’s comments on his team’s 2009 season spring to mind. 

He said they had improved their ability to play the game, and definitely improved the culture but depth was still an issue. It’s the same here, and so like the ABs, seven is what I would give the PHO as a score out of ten. We haven’t quite reached the giddy heights of the All Whites but on current form we are doing better than Tiger! I’m pleased with the speed the organisation is moving so below is a quick lap of honour of the highs and lows. 

Our programmes

As Turanganui PHO pulled into 2009 it began to strengthen its the quality of services. The best examples are HealthRight and the Cardio and Pulmonary Rehabilitation programme. HealthRight Lifetime Lifestyle is in its third year and five of the six general practices are now offering it. I know staff patience can sometimes still be tested but volumes are increasing and a Pinnacle problem-solving team continues to help us iron out the creases. As for Cardio and Pulmonary Rehab, the PHO has already signalled this service will be continued next year.

Some programmes weren’t as successful. This year saw the beginning, then demise of one programme: Work and Income’s Mild to Moderate Health Intervention contract. While the programme’s ultimate demise was an external decision, I said at the time the service had been underutilized and may not have continued anyway. 

Our involvement in Sport Gisborne Tairawhiti’s Active Whanau Health Initiative (AWHI) also came to an end. Over time it became harder to encourage families to take part in the programme and we have now channelled its funding into another of SGT’s programmes.

General Practice

General practice has enjoyed a busy year. There was minor change for Desmond Road Medical Centre in March when it became the last general practice to go with the Very Low Cost Access payment option meaning reduced fees for patients. It’s great to be able to say Turanganui PHO general practice fees remain some of the lowest in the country. 

Fantastic news arrived this year in the form of five GP trainees. Tairawhiti District Health’s GP Liaison Dr Patrick McHugh smoothed the way and it wasn’t a moment too soon.  Patrick tells me it took him nearly a year, working with the Royal New Zealand College of General Practitioners and local GPs to bring in the fresh crop. 

New faces

Other new faces working with Turanganui PHO this year included HealthRight and Project Nurse Carol Ford, and HealthRight Medical Advisor Fergus Aitcheson. Carol brought skills useful in a number of settings, and Fergus was extremely helpful in promoting devolution discussion. We also welcomed a new Board member this June, Diane Cooper, who brought with her a drive and determination for helping achieve our business and strategic goals.
 
Around the same time the entire region welcomed a very undesirable newcomer in the form of H1N1 influenza. Kaiti Medical Centre GP Tom James diagnosed the first person in the district with the virus. It was a worrying time for many and I congratulate front line staff for their handling of patients during this time. 

Reaching targets

Despite swine flu and the increased winter workload general practice staff this year continued to meet and exceed milestones set. Of particular note; the percentage of cardiovascular disease (CVD) risk assessment screenings exceeded national and regional targets. 

There was also a high standard of achievement for cervical cancer screening according to the Performance Management Programme (PMP) results. Three quarters of eligible women in our area were screened in the past three years, and we also recorded good results for immunisations of two-year-olds.

Diabetes Annual Reviews are counted by Pinnacle and this year our general practitioners and diabetes nurses completed 870, 110 more than last year. And as if all that reporting and regulation wasn’t enough, what wrap up would be complete without mention of the Quality Plan? Congratulations to City Medical Centre, Mangapapa Medical Centre and The Village Clinic for being the only three practices to achieve a blemish-free copy book! 

Turanga Health must be congratulated for the work done with Robyne McKeague helping staff become more IT competent and confident. Robyne is our Pinnacle Practice Liaison and without her I don’t think the 1000 tiny jobs that no one cares to remember (but quickly notes when they have been done!) would ever be achieved. 

Change ahead

As the year draws to a close we find ourselves on a precipice of change. I and others from the district’s health sector were involved in a proposal for a new look primary health sector. As noted by The PHOnetic last month the devil is in the detail, but I look forward to sharing, moulding, and developing this model with more of you in the weeks and months to come. 

On a more personal note a highlight for me this year was the completion of my Masters in Public Management. It’s taken three years and at the midway point of every semester I thought ‘I shouldn’t do this again’.  Then in the warm afterglow of passing papers I’d think ‘yes I should!’ 

On Christmas Day the Brooking whanau will be in my home town of Oamaru. It’s a long drive and I will be reminded as a youngster of making the reverse trip, Oamaru to Wairoa, sitting in the back of the Holden Kingswood station wagon. How lucky my son is to have his journey cushioned by air conditioning and portable dvds!

Thank you to those who are working during the holiday. Your commitment to the health care of others is exemplary and I trust with a bit of planning, you will still be able to enjoy all that the season brings.

Have a safe Christmas and a happy New Year,

Keriana.

Images by Brett Mead

Hats off to the 140 aunties and uncles who took part in the hilarious and sometimes outrageous Kaumatua Day Christmas Party last week!

The annual end of year bash is a chance for kaumatua and staff to wrap up the year with a bit of fun and a feast ahead of the Christmas New Year break. 

Coordinator Kay Robin has managed the social and education programme for older whanau for 18 months taking over from Tanya Coleman in April 2008. Kay says a Needs Analysis was done at the same time, giving her and the staff an opportunity to tweak the fortnightly format. 

While the programme remains Marae based with a health focus, now, every six weeks there is a defined social, kaupapa or health workshop focus. Transport is provided to and from the programme for free, and health checks including blood pressure, blood sugar levels and weight continue. 

Whanau spoken to at the party said highlights of their year were visits to Eastwoodhill Arboretum, Morere Hot Springs and Tairawhiti Museum. 

This year’s Christmas Party was at the Gisborne Cosmopolitan Club and featured a Christmas Hat competition and music and banter from Turanga FM DJ and crowd favourite Walter ‘The Wiz’ Walsh.

Turanga Health’s Albie Stewart has been seconded to Turanganui Primary Health Organisation to help with the Midland region’s business case for an improved primary health sector. 

Albie, who has Rongowhakaata and Tuhoe tribal affiliations, will assist Turanganui PHO chief executive Keriana Brooking and others across the Midland region as they work at a fast pace to complete a business case by February 15. 

The work will involve offering advice, validating perspectives, suggesting ideas and taking the opportunity to frame how this new way of delivering primary health care might look in Turanganui-a-Kiwa, Tairawhiti.

The new Midlands business case includes 16 individual project areas that together form the new business case. 

“An on-line social networking system has been set up so people interested in these project areas can contribute their ideas, views and opinions,” said Albie.

“The good thing about the social network is that external parties can be invited to participate, providing an environment of robust discussion and involvement during the writing of the business case as opposed to commenting at the end.”

Albie has temporarily left his role as Turanga Health’s Personal Health Manager, a position he has held since August 2006. He was managing clinical and non-clinical services offering a one-to-one service to whanau.

Albie’s involvement with Turanga Health actually began over a decade ago - he was a founding director and inaugural chair for the organisation that was established in 1996.

Over the years Albie has gained a lot of management and service delivery experience managing Opotiki’s Te Ao Hou Primary Health Organisation for 12 months and before that managing Te Whanau a Apanui’s health and social services in Te Kaha.  Albie has one final paper to complete to gain a Masters in Public Policy degree from Victoria University.

He remains passionate about finding a practical approach to whanau ora in Turanganui-a-Kiwa that involves not just health, but areas that include welfare and education.

“There are organisations tasked to achieve economic, cultural and social well-being for Maori, but they are missing the chance of developing something tangible that is more likely to produce whanau ora in its entirety, not just health,” said Albie.

“We need to show our mokopuna, our leaders of tomorrow, these good habits of wellbeing now because it will not be long before they will take over and be subjected to the physical, mental and spiritual challenges that face them.”