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National Park

Participants felt that due to difficulty accessing both preventative, early intervention and emergency care, people who lived in National Park tended to delay seeking medical treatment:

"I think one of the bigger problems here is the very independent mountain mentally that, until something is falling off and you've rung every former ski-patroller, fire fighter, and someone whose mum used to work for the Plunket Nurse, then you might actually call for assistance. Because it's at least 30 or 40 minutes to Taumarunui, our closest ambulance station here, that leads to delays. Sometimes they'll come out and something's well-developed or too late. On the upside the ambulance station is equidistant from Taumarunui, Tūrangi and Ohakune.... and you've also got lots of nice flat places to land helicopters. So it's a bit of a balancing act. But I think that independent spirit is one of the biggest health hazards out here. I think people are just, oh, we want to sort things ourselves. Or they'll go racing into the hospital and create a hazard themselves with a kid under one arm driving with the other arm..."
"Yes, head out the window because the windscreen's frozen!"
"But from that health side of things it is a big sort of thing, you know, call... call early. But a lot of the times there's a massive delay before someone officially calls for help for both health conditions and accidents and injuries."

Despite acknowledging the need for early intervention, participants recounted difficulties accessing primary care in Taumarunui, but felt that primary care was slightly more accessible in Raetihi:

"Even just signing up for the doctors in Taumarunui. That’s where I was told to go. After doing my application form I was told it would take up to two months to get a doctor’s appointment. For me, who has medication that I need, I had to drive to Hamilton back to my old doctor to get that."
"I changed from Taumarunui to Raetihi."
"If you ring them (Raetihi) up with something and you need to see a doctor now, they will make space for you, but I think for something more routine they will try and book you in later."
"They (Raetihi) do shift you if you’re just going for a repeat and your time has come up. But they are very good at sending me texts, saying you’re due for a blood test, or due for this. So you know, but very bad experiences at Taumarunui."

Residents of National Park experience difficulties accessing secondary care, which was noted as particularly arduous when treatment is ongoing:

"I've had serious health concerns in my journey here and I had to, for treatment, I had to drive to Palmerston North Hospital once a week, every week for three months. Then, yes, and overnight there and then come back."

As in 2020, a significant challenge or concern for residents of National Park was their position on the cusp of then different DHB areas for secondary care. Now, noting that DHBs have been disestablished, participants still felt this issue remained:

"We're sort of on the boundary."
"But it's some people go to Whanganui, others will go to Waikato."
"It's a super significant issue, actually. Because we're on the boundary and there’s meant to be no DHBs now, but they basically always want to send you North. I was having a conversation with someone on Sunday night, works out of Whanganui and he wants the referral out of Whanganui because it works for his job. I always want to be referred out of Palmy because (redacted). But they send you up to Waikato and even through now we're meant to be no DHBS they still want to send you that way. It's like they can't recognise that our address may be aligned to Waikato but by hundreds of metres. Our lives might be anywhere else. And that is hugely inconvenient."
"The closest major hospital here is actually Taupō".
"It is, it's got way more facilities than Taumarunui so if you need to get into a hospital with a surgical wing then that's actually closer. During COVID Taupō was the closest COVID receiving hospital.... but there's this invisible line which is meant to be removed now. But no one's updated their plans."
"Yeah it's so annoying. And it is, it is emotional wellbeing. Because if your support people are in a different place, you can't actu.... like when I was going to have my kid, one of my children. And I was being forced to go to Waikato. And it was like, but everyone I love and that will care for me is in Whanganui. I don't want to go to Waikato, but they just can't seem to see beyond it. That is not an insignificant issue, it is hugely annoying."
"Losing the DHBS, they’re not replaced with anything. They’re replaced with Te Whatu Ora which is a great big amorphous thing. You used to have, as part of your local elections, you used to elect your DHB board and so at least you had a name that you could ring up or email or vent. Now that this has been replaced with this void there's nowhere to even go to... to raise an issue. They have a monthly meeting in Taumarunui where TWO (Te Whatu Ora) staff come and talk to the community and all that and they note things down. But that's not enough and that group needs to come to outlying communities as well because they can't get in or don't even know about these. Because we are almost spoilt for choice because we're right in the middle of what used to be three DHBs, everyone thinks it's someone else's problem - one of the others will pick it up. Every time I go to my specialist in Rotorua, they go, "Hang on, you live in the old Waikato DHB, your doctor's in Whanganui old DHB, but the specialist who referred you to us is in Taupō. Ok, well, we're not going to bloody... we'll just do it." But every time we have the same conversation."

Transport was also a barrier to accessing secondary care even when a bus was available:

"On a slightly more positive side there is a health bus that runs Monday to Friday to Waikato with stops all the way up to Hamilton. The trick for people here is to get into town early enough to get on it. What the DHB was doing for some patients is they get whānau to take them there, put them up in the motel and arrange for them to get on the bus that day and coming back it doesn't get into about six to half past six and again, if they couldn't get met by whānau when the bus comes in, put them up in the hotel and their whānau would pick them up in the morning. It's not easy".
"I have a (redacted medical treatment) on Friday which is fairly significant, but I can't get there because I can't drive, there are no taxis, ACC will pay for a taxi but there's not taxis. So I can't get there so I have to phone up and say, “Well, you're going to have to delay it because I can't drive.” It's really debilitating if you can't drive in this area."
"I’ll take you, if you want, because I need an excuse to go shopping."

Similar to 2020, participants were also concerned by a lack of mental health services in the area, though noted some service availability in Taumarunui.

"I’m yet to be able to find out if there’s counselling or local support services like that. Psychology and trauma... to help my family talk about it to someone else. I haven't found anyone. I've been referred to one person in Taumarunui, but she comes down from Auckland once a week."
"There is a mental health in Taumarunui there. I've only sort of come across it, but it's Monday to Friday, eight 'til five, which is better than what we had before which was nothing. But if you have an event after hours or weekends or public holidays, you've really only got the 0800 numbers. It is a big thing here. When they have teams available, they're really good."
"If you go through Raetihi you get sent initially to Whanganui Hospital, but the specialists at Whanganui Hospital come from Palmerston North. And I don't think the Palmerston North Hospital has a good reputation for the for mental health services. So it really does just depend on who and where."

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