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Pahiatua hospital loses its brave fight for survival

(Pahiatua Hospital - view from above)

ABOVE: Looking down on a hospital which now has only 30 staff and 15 elderly patients who are waiting for the new unit, Waireka Home, to be built

(Pictures by NIGEL HARRIS)

In just four years Pahiatua Hospital would have celebrated its centenary. Instead, the hospital is in the throes of closing. Evening Standard health reporter RACHEL FORDE found sadness but also resilience and optimism when she visited Pahiatua.

(J Rossiter) (L Nelson)

ABOVE: Friends of Pahiatua Hospital Society chairwoman Jeanette Rossiter, left, and nurses co-ordinator Lorraine Nelson

(A bare corridor)

ABOVE: A bare corridor leads to the old x-ray department

THE closure of Pahiatua Hospital has been on the cards for the past few years, with talk of its impending demise being bandied around in 1992.

But the then Manawatu-Wanganui Area Health Board assistant general manager Janice Wenn said talk of plans to close the hospital were "100 percent wrong".

She said there had never been any question of the hospital closing, it had never been discussed and wasn't on the agenda.

Four months later bed numbers were cut from 23 to 18 but management still said the future of the hospital was not in doubt.

Midwifery staff were put on special contracts so they would only be employed while there were patients in the ward.

In 1994, Mid Central Health ended its first year as a crown health enterprise in debt, to the tune of $4 million.

Mid Central Health said it was in considerable financial difficulty and projections showed it was not viable.

Once again Pahiatua Hospital was under threat but the axe didn't fall until November last year.

Mid Central's chief executive Margot Mains announced the closure of Pahiatua Hospital, saying there was not enough money coming in to keep it open.

Forty-seven fulltime and part-time staff lost their jobs and 15 continuing-care patients were told they no longer had a permanent home at the hospital.

The community reeled from the impact, which came hot on the heels of job losses at Tui's milk plant.

Emotions ran high at a meeting called to discuss the closure, with people breaking down and tears flowing freely.

Submissions were written and petitions signed, but nothing could save the hospital and it has gone the same way as Greytown's hospital.

It has slowly wound down and services have been transferred to Palmerston North Hospital or are no longer offered.

Women giving birth now have to travel to either Dannevirke, Palmerston North or Masterton.

People needing X-rays have to make the journey to Palmerston North and, while Meals on Wheels has been given a short reprieve, the writing is on the wall.

The full effects have yet to be gauged, but one thing is certain — the community whose forebears relied so much on the hospital nearly 100 years ago will not forget why it was closed.

Last November the town learned it would lose its hospital, a sprawling collection of buildings at the southern entrance to the town.

Palmerston North-based Mid Central Health announced it could no longer afford to keep the hospital open on the funding available from Central Health, now part of the Health Funding Authority.

The hospital would be closed on June 30, 1998, chief executive Margot Mains told the hospital's shocked staff.

The town was outraged.

A Save the Hospital group was formed, and a 3342-signature petition was presented to Parliament protesting at the closure.

Central Health agreed to fund a new continuing care hospital for frail elderly people who needed long-term care, plus a few beds for people with chronic medical conditions and the terminally ill.

Last month, Pahiatua's Waireka Home announced it had won this contract, and would add a 20-bed continuing care hospital unit to its rest-home in Halls Rd. MidCentral Health agreed to continue caring for its 15 long-term elderly patients until the new unit was ready.

But the X-ray department, maternity beds and GP-supervised medical beds closed on June 30.

There was sadness and resignation but surprisingly little bitterness at the hospital last week as beds were stripped and left bare and the remaining patients moved into one ward.

Four hospital staff have left for other jobs since November, and about eight finished work on June 30.

The remaining 25-30 nurses, cleaners and kitchen staff will stay on to care for the remaining patients until the unit at Waireka is ready.

The Friends of Pahiatua Hospital Society, which has raised thousands of dollars to buy equipment, furniture and appliances for the hospital, is reclaiming the donations.

Chairwoman Jeanette Rossiter said there was no way the society was going to sit by and see things provided by the Pahiatua community disappear over the ranges to Palmerston North.

Soon after the closure announcement, society members scoured the hospital and attached stickers to everything they identified as having been donated.

Mrs Rossiter said these would be offered to Waireka Home for its hospital unit, so Pahiatua people could continue to benefit from the things they raised money to buy.

Society secretary Joan Cowley said she still couldn't understand why the hospital had to close.

It seemed as though the opinions of people who lived in the town didn't matter.

A nurse said the hospital had filled a valuable role in the town.

"If your grandmother or elderly mother wasn't very well, they could come into hospital until they got back on their feet," she said.

"Palmerston North Hospital doesn't consider those sorts of people to be sick enough to admit.

"But they're not well enough to be at home either."

Another nurse said she feared for the future of the large number of low-income Pahiatua people — particularly young families and the elderly — who had neither a phone nor transport.

She took a call one Sunday, when no doctors were available, from a woman worried about her 18-month-old baby.

Realising that meningitis was a possibility, the nurse advised her to take her child to Palmerston North Hospital to have her checked.

But the mother said she was on a tight budget, and couldn't afford the extra petrol to get to Palmerston North.

The nurse suggested she phone for an ambulance, but the woman said she couldn't afford to pay the $45 ambulance charge either.

Fortunately, the child recovered.

Nurse co-ordinator Lorraine Nelson started work at the hospital 11 years ago where there was a women's ward, a men's ward and a maternity ward.

She said staff had experienced the whole gamut of emotions since the closure announcement.

"There have been ups and downs. At times, people have almost been on a high; at other times, they've been really down."

Mrs Nelson said a few nurses would probably choose to take early retirement, and others would probably get jobs at Waireka Home's new unit.

She is convinced rural hospitals still perform a useful role, even in an era of high-tech medicine.

"All the services we have provided here met a need in the community."

During busy winters, such as last year's, the hospital's 11 medical beds were constantly full, one patient being admitted as soon as another left.

In quieter periods, there would be just two or three medical patients.

"One of our biggest roles has been to support bigger base hospitals like Palmerston North by providing convalescent care, palliative care and rehabilitation services.

"We've also been able to give our mothers the time (they need) to recover from the birth and to get to know their babies.

"So when they go home they have confidence they can cope."

Because of Pahiatua's size, staff often knew many patients personally, which gave the hospital a family feel. Pahiatua GP Gareth Devonald remembers performing operations at the hospital in the 1970s and 1980s.

When he arrived in the town 23 years ago, there were two operating sessions a week.

He and two other GPs did minor operations such as hernias and removing tonsils, adenoids and varicose veins.

Surgery stopped in the mid-80s — "as it should have, because it could be done better and more safely in a bigger hospital".

After that, the hospital's scope was gradually reduced. "We used to admit children with asthma, for example.

"But then it was deemed that, if they needed to be in hospital, they needed the specialist care of a big hospital.

"This is a low-tech hospital, and if anyone needs a lot of technology they really should be in Palmerston North Hospital.

"It's all changed now, but in many ways it's for the better."

But not all patients require expensive technology.

Some just need observation and nursing care, and he believed there was still a role for rural hospitals.

He said it all came down to economics: whether a government was prepared to pay enough to keep rural hospitals going while also investing money in expensive new technology in larger hospitals.

He said the growing range of regular specialist outpatient clinics offered by Mid Central Health in the town was a big improvement.

It meant people could attend pediatric, ear, nose and throat, podiatry, psychiatric, orthotics and diet and geriatric clinics without having to travel to Palmerston North.

"There's no point in our trying to be controversial and angry now. "We have to accept what's been done and go forward."

MidCentral Health hasn't yet decided what to do with the hospital buildings and grounds, now valued at about $1 million.

It is looking for a new site in town for its outpatient clinics and community services.

Save the Hospital group secretary Mies Oomen says the hospital belongs to the community, since it was paid for from their rates.

If the land and buildings were sold, the money should be spent on services for Pahiatua, Eketahuna and Woodville districts.


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