Island Nurses by Howie Leonie; Robertson Adele; & Adele Robertson

Author:Howie, Leonie; Robertson, Adele; & Adele Robertson
Language: eng
Format: epub
Publisher: Allen & Unwin
Published: 2017-03-16T16:00:00+00:00

We had seen a kind of tidal ebb and flow in the former days of the Department of Health. Sometimes the people in decision-making positions understood the demands and requirements of rural nursing. Sometimes they seemed to think that it was little different to working in a well-stocked clinic in a leafy suburb with straightforward access to all main transport modes and all medical mod cons.

The vehicles that Adele and Nancy were finally supplied with reflected the degree to which the urban managers misunderstood what it meant to try to supply health services to the sparse population on a mountainous island with a very poor roading system. Adele’s first Health Board vehicle was a Toyota Land Cruiser (Nancy had a four-wheel-drive Suzuki). But when the time came to replace them, there had been a change in personnel in the vehicle procurement department. It was decided that Nancy should have a station wagon and they sent Adele a boxy little two-door four-wheel-drive Lada. Nancy did what she could with the station wagon, but island conditions took their toll upon it. When it went back to Auckland full of dust and with all the doors rattling, Nancy was accused of not caring for it.

Adele’s Lada stood up to the rigours of the roading rather better, but she couldn’t fit her patients in it, and it was so poorly designed that she developed a repetitive strain injury in her left shoulder from the difficult gear changes. She grew to loathe the vehicle. But the day was at hand when she could get shot of it, and ensure that its replacement was much more fit for purpose.

In 1992, Adele and Shannon attended a one-week intensive small-business course that was run on the island by the Auckland New Venture Trust. They had finally got their mussel-farming venture off the ground, and the course introduced them to some of the processes needed to operate a small business—such as wrangling taxes like PAYE and GST, and how to write a business plan. Ivan and Leonie were there too, as their medical practice was growing fast. Little did we all know that we would be using the skills we acquired to take Great Barrier’s health services another quantum leap forward.

In July 1993, New Zealand’s health system was radically reformed. Funding and procurement was shifted from the Department of Health, which was renamed the Ministry of Health, to newly formed Regional Health Authorities (RHAs). The management of the Northern RHA (North Health) was largely in the hands of people who wished to improve health-service delivery and reduce costs, and, consequently, they were far more receptive to suggestions for new and better ways of providing services. We all immediately saw the opportunity that the brave new funding model presented. It might mean that we could finally set up a comprehensive health service tailored specifically to meet the needs of the people of Aotea.

So together we wrote a business plan, describing the community’s health needs—rated as ‘remote rural’ in the official

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