The Taranaki District Health Board has backed down on a proposal to limit access to the emergency department at Hāwera Hospital after hundreds of locals came out against the idea.
The health board had proposed allowing only patients who turned up in an ambulance or had been referred by a GP to be treated at Hāwera ED.
But the DHB's chief executive Rosemary Clements told a meeting of the South Taranaki Community Health Forum yesterday that it would remain open access.
"Absolutely, until we can get some solutions into the primary care system you can't take a service away that would be absolute dynamite for the community.
"So no it's the status quo while we get it all sorted out."
But that's a far cry from the message conveyed in a letter the DHB - which is $28 million in deficit - sent on 26 July following an Acute Demand meeting with South Taranaki health providers.
The letter spelt out the DHB's desire to reduce the number of people using the Hāwera emergency department for non-urgent health concerns.
"In this context, the Taranaki DHB is proposing that Hāwera ED is used for emergencies only and is looking to achieve this by making entry to the emergency department by GP referral or ambulance," said the letter which was signed by Ms Clements.
Although in the same letter - in bold type - it stipulated this "does not mean we are closing down Hāwera ED" alarm bells were already ringing around South Taranaki.
Yesterday Ms Clements admitted the DHB's messaging could have been better.
"I think sometimes when it comes to your local health system and your access into that people naturally become concerned and particularly in rural communities.
"So I think there was a little bit of miscommunication and I think maybe the trust isn't there in the DHB that we'd like."
The rate of ED presentations at Hāwera is almost twice as high as in New Plymouth and only fractionally better when compared to Stratford.
Neither Hāwera nor Stratford have an after-hours clinic.
The DHB said 64 percent of ED presentations in Hāwera are for non-urgent health issues.
Ms Clements said it was in that context that the DHB wanted to discuss how to convince patients to use primary health providers where it was considered they get better care long term.
"So while there might have been some discussion about how you would look at that: whether it be would that be ambulance, would that be GP referral; there's an absolute acknowledgement that nobody coming to the ED is going to get turned away for no reason.
"That's never going to happen. We are always going to do an assessment and make sure those people get the care they need in the right place."
Long-term outlook for care remains a concern
Te Rūnanga o Ngāti Ruanui Trust kaiarataki Debbie Ngarewa-Packer was behind the public show of support for the emergency department.
Ms Ngarewa-Packer, whose organisation runs two health providers in South Taranaki, said the ED has been given a reprieve but that's all.
"Well, I mean we've got a stay and it's good to know there is a little more certainty because there was such a lack of clarity in what they were proposing.
"But it does worry me that the only plan they have is based on the proviso that the health providers here will pick up the slack. There wasn't a Plan B evident."
Ms Ngarewa-Packer said the original proposal had failed to take into account the chronic GP shortage in South Taranaki and the fact Hāwera did not have any after hours clinic or pharmacy service.
"No-one disagrees that emergency services should be for emergencies but the specific problem is that we have overwhelmed services here and we have a shortage of doctors so where do the 4000 people who are not registered, where do those who are using the emergency services after hours go?"
Protesters say ED essential at present
Among those involved in the protest yesterday it was clear until better services were available, the ED had to remain open to all.
Murray Root, 81, had used the emergency department a couple of times recently.
"All I can do is just walk up there and I don't want any restrictions on that because it comes to be a life and death issue. They are not realising that people can die from this because of lack of attention quick enough."