Tairāwhiti people are passionate about the health of our young people and want to make sure the best care is available to all. How this can best be achieved is being debated. Further questions about Hauora Tairāwhiti’s decision to cease the contract with a local General Practice to provide a GP service in three local secondary schools have been raised in letters from students at Gisborne Girls High School.
We recognise that all parties involved with the GP service remain passionate and committed to the care of young people, says Hauora Tairāwhiti Planning and Funding Manager Nicola Ehau. “We continue to value this commitment.”
“After looking at the numbers of people using the service, the conditions treated and the cost of the service, it was agreed that there is a better way to provide for our young people especially for those with higher needs.”
In 2019, 326 young people (out of a total of 2500 students in the three schools) were seen by the GP service. This is less than 15% of all the people attending the three schools and less than 7% of the 5000 students in years 9-14 in Tairāwhiti. The service cost $124,000 per year.
The top six conditions people went to see a GP in their school for (in order of use) are contraception, sore throat, asthma, eczema, acne and sprains. Contraception and sore throat (rheumatic fever throat swabs and treatments) are available free of charge from every GP practice for all young people. Both asthma and eczema are best treated through consistent monitoring by a care team that has ongoing engagement with the person and their whānau. Young people recognise this. In a Gisborne Girls High survey, each age group responded that they prefer to see their own GP. ‘I’d rather go to my own doctor because they know more about me’.
Fifteen per cent of people that were seen with sprains were as a result of accidents. These are covered by ACC. Each month 1-2 people were referred for counselling.
The GPs in schools service started 15 years ago. Since then there have been a lot more services made available to youth that previously wasn’t there, adds Ms Ehau. “GP services are now free to young people up to the age of 14 years as are sexual health services for people under 25. There has been an increase in the nurses in schools service with extra funding from the government in last year’s budget. Pinnacle Health Network now offers youth mental health support.”
“Improving access to primary care services is a priority for us, young people have commented that they go to their local GP practices when required, and don’t see this as their main area of concern.”
“Freeing up the funds previously spent on GP in Schools allows us to consider what else can be done to reduce the equity issues for youth 10 – 19 years of age, particularly in our coastal and rural communities, says Ms Ehau. Opportunities to improve the health of young people, especially those with high needs; or are not high users or don’t access health services at all, are being considered.”
“We know from feedback received that rangatahi have talked about having their own ‘space’. Services have been available to young people. Those services have done little to remove the barriers for young people to easily use them. In some parts of Tairāwhiti, there is little or no service for young people i.e. lack of dental services to coastal communities.”
Establishing two ‘hub’ type ‘spaces’ for rangatahi have been proposed, one centrally-based in a Gisborne urban setting and the other in Ruatorea.
“We are looking at spaces and activities that young people are drawn too; as opposed to a clinical health-specific service. What’s relevant and appropriate for young people also applies to the spaces they access. Health needs to be working in places where young people are drawn to for their own interests or reasons. We would focus on prevention and early intervention.“
“In the Hauora Tairāwhiti Population Health Team part of some of the staff’s roles respond to youth health needs including sexual health, youth resilience and suicide prevention /postvention. Our approach is to consider how these roles can work more capably within a community development model. This is consistent and would align well with work occurring in other agencies, organisations and Iwi. Additionally, it supports the shift of services closer to the population most needing support.'
Initiatives being considered are:
- co-locating roles in youth spaces with access to support. Resources would be provided via this method,
- supporting youth in coastal and rural communities. This would be done by connecting and supporting communities to build methods and tools they identify as helpful and will be used.