Page 89 - Regional Services Plan 2016/19

Chemotherapy
Taranaki DHB (local)
Waikato
Medical oncology and radiation oncology Chemotherapy
Waikato DHB (local)
Haematology
Waikato DHB (local)
Future trends
Volumes of cancer services rise sharply with age; hence total volumes are expected to increase significantly with the ageing population. Since cancer services are a mainly outpatient and day service specialty, the impact on future bed days and CWDs is limited. However, the total service requirement will increase by a similar percentage to that foreseen in medical services – some 60 percent by 2026 – and the rise in associated costs is likely to be even greater.
3.4 Women and children’s health services
Current service availability
The Midland region currently provides 24/7 access to general obstetric, neonatal care and paediatric services at each of the major DHB hospitals. Waikato provides the majority of very highly specialised paediatric and obstetric care, with sub-specialty very highly specialised back- up provided by Auckland DHBs. Local provision for paediatric subspecialties generally consists of local paediatricians supported by visiting paediatric subspecialists
It is of particular interest that maternity/neonatal services have clearly evolved to achieve high level services to at risk populations. This is a clear reflection of response to community needs.
Significant numbers of Midland babies are born in the smaller rural health centres or primary birthing centres. The Midland region is well served by small rural hospitals providing birthing services. However, small facilities have tended to have difficulty maintaining financial and clinical viability. Lead Maternity Carers (LMCs), usually midwives, are required to have a backup LMC (another midwife, and/or an obstetrician or GP) at each birth – requiring two people to be on 24 hour call in each area. This requirement can make it difficult to provide birthing services in rural areas.
Future trends
Both maternity and paediatric CWDs and bed days are projected to decline for non-Māori over the next 15 years – particularly in Taranaki, Tairāwhiti and Lakes. Māori CWDs and bed days are expected to increase. These trends may mean that in order to sustain the service revised service delivery and funding models are designed to maintain those services that it is important to retain.
Maternity and paediatric services are critical services for populations: the Role Deliniation Model (RDM) suggests that they, along with diagnostic support, develop in advance of other services. The rationale is clear: obstetric services are a core service which remains difficult to regionalise without adverse outcomes. Many DHB services in smaller places, e.g. Gisborne, develop ‘outward’ from critical provision: there must be obstetric, which means paediatric, support which means anaesthetic support.
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