Babies 'bearing the brunt' of health system complications as preventable hospital admissions rise

There's just multiple layers of complications right now, and our babies are unfortunately the ones bearing the brunt of it

A spike in the number of preschoolers being hospitalised for illnesses that should have been picked up earlier is worrying, an Auckland GP says.

The latest Te Whatu Ora figures show in June, preventable hospital admissions for babies and pre-schoolers shot up by 35 percent compared with the same time last year.

Henderson GP and Māori clinical advisor to the Immunisation Advisory Centre, Dr Mamaeroa David, said her practice had recently closed its books because patients were waiting too long for appointments.

"When I do actually see the patients, it's a very complex appointment because they've had to wait three weeks to actually be able to talk about what's been worrying them.

"There's just multiple layers of complications right now, and our babies are unfortunately the ones bearing the brunt of it."

Her clinic reserved eight appointments every day for children with urgent needs, but it was still not enough to see everyone, David said.

The data showed a surge in the number of young children admitted to hospital with asthma, pneumonia, upper respiratory and ear, nose and throat infections, as well as gastroenteritis, dehydration and cellulitis.

Preventable admissions were up nationwide, but Auckland was hit particularly hard with rates soaring by more than 60 percent.

Pasifika children aged zero to four were worst-affected, with their hospitalisation rate increasing 45 percent.

David said the number of viral infections made it feel like one long 18-month winter season, with children bearing the brunt of the pressures on primary care.

Māori paediatrician and incoming president of the Paediatric Society Dr Owen Sinclair said the data showed how inequitable Aotearoa's health system was.

"Our health system really does have winners and losers. Certain groups have always done much worse than others, it depends where you live, it depends what ethnicity you are."

The most sensible response would be to focus more resources on prevention, he said.

"If our hospital system is getting inundated with children with amenable diseases, a smart thing to do might be to invest in processes that stop them [becoming unwell] in the first place," he said.

Royal College of GP medical director Dr Luke Bradford said the data painted a grim picture.

"The fact that we saw an almost universal decrease in performance was a bit of a disappointment," he said.

"I think it's reflective of an entire system that is under strain. We're seeing people not being able to access the secondary care, and then the prolonged waits for surgery meaning they deteriorate and then put more strain back onto the primary health system as we try to manage them through waiting."

Doctors had been calling for a review of the system, he said.

"We've been calling for many years now for a proper review into how we structure and resource primary care."

But those calls had died down with the formation of Te Whatu Ora.

"[We] hoped that a whole system restructure would bring benefits, but we're not seeing that yet," he said.

"We need a complete review of how and when patients present. We need increased resourcing and a review of how capitation works to better target to those with the highest need, and to allow practices to get on and firmly recruit."

Te Whatu Ora clinical director Dr Richard Sullivan said the metrics were concerning.

"We're pretty disappointed in the results," he said. "But on the positive side we've done just under 20,000 more operations this year, so the system is starting to respond to these challenges."

He said prevention would be a key tool in addressing the system's issues.

"The focus of Te Whatu Ora is to shift towards communities and preventing illness.

"Immunisation is a really good example of that, if we can immunise our population we know that reduces [hospitalisations]."