Innovative Ideas Register

Te Korowai Ora (The Cloak of Health) Kura Whanau GP Clinic

Development of the Initiative

This initiative is a joint venture between General Practice and Public Health which offers free general practice care to a population group which, in the past, has not fully accessed mainstream primary care. Changing the way Primary Health Care is delivered in our community has allowed for an enhanced uptake of services.

Students and their whanau/whanui can attend the free clinics held one day a week at Te Kura Kaupapa Maori o Wairarapa. Services offered at the clinic include cervical screening, child health (eg, ear checks, especially following failed hearing tests at school), timely treatment of skin infections, minor surgery and chronic disease management (eg, diabetes, hypertension, congestive heart failure).

The objective was to reach into the heart of the Maori community to a place where many Maori throughout the Wairarapa District had access — their school. Often uncomfortable with, or unable to access the mainstream health services due to many kinds of barriers (cultural, financial, location, etc) many families did not have a regular GP. Now with funding and support from the Wairarapa DHB the clinic has grown into a popular family based service. Furthermore, the wider family can also attend. Public Health nurses now have early access to a doctor for any family or child they see in their work. Although the clinic sees over 90% Maori, Pacific people and NZ European are welcome to attend. Given the well documented disparity in the health statistics of Maori to Non-Maori this clinic is well placed to begin to address these needs in a site that is well accepted to Wairarapa Maori.

Results

This innovation has had a highly beneficial effect on the health of the Kura whanau. This is seen by the numbers who have felt comfortable to use the service (600 encounters in first 12 months for the funded 136 hours). There have been many patients who have resumed medications that were inappropriately stopped through lack of GP contact, many screening procedures initiated, and much “health literacy and assertiveness” attained.

Return to the ‘mainstream’ service for after-hours care is more commonly sought now.

A holistic view of child health is taken, where trusting relationships have developed between whanau and the doctor which allows for effective Health Promotion as well as more immediate health needs being met. For example, healthy eating, exercise and smoking cessation programmes will result in positive health gains for the whole family, not just the person attending.

Moreover, there has been heartening community backing from a wide range of other provider groups such as Iwi agencies (Whai ora Whanui, Te Hau Ora Runanga O Wairarapa), Plunket, Truancy Officers, Police and CYFS. The nurses have aided with the recent appointment of a practice nurse working equal hours with the GP. This innovation has seen the community acting cohesively to ensure patients with treatable conditions can be seen early, making intervention more effective and often avoiding the need for hospital admission. It has been a small but empowering innovation for this community. The DHB and local community are now seeking a wider coverage with clinics in other areas of the Wairarapa.

Primary Contact

Dr Cath Becker
General Practitioner
Choice Health
24-26 Chapel Street
MASTERTON

email: Katarinabecker@yahoo.co.nz