Pacific children hospitalised unnecessarily due to barriers to primary healthcare

July 01, 2021


​By Paige Faigaa - Paige.faigaa@pmn.co.nz

Pasifika children struggling to access primary healthcare are ending up in hospital for preventable reasons.

A government-funded report that analysed data from nearly 6000 children​ suggested close to ten per cent of Pacific children, aged between three and four experienced "great barriers" such as costs and transport to seeing a GP. 

The Prevalence and Consequences of Barriers to seeing a GP report, also suggests those children who don't see a GP are nearly three times more likely to end up in hospital years later.

"If you're ending up in hospital for a reason that could've been preventable when you're four and half, imagine the social impacts it's going to have, the impact on schooling, and the impact on other children in the family​​.​

"All hospitalisations that have been looked at were things the Ministry of Health has identified as  preventable if primary healthcare is accessible and effective," says lead author Doctor Mona Jeffreys.

Costs, transport and appointment availability were identified as major barriers.​

Jeffreys says: "We've known about this for a long time, but it's another piece of evidence to show that the system is not working for Pasifika and Maori children.

"For Pacific children the biggest barrier was not having transport to get there, and that's such a simple thing to correct yet its such a huge barrier for some families."

However, South Auckland GP Doctor Api Talemaitoga says it's too simplistic to boil it down to costs and economics.

Children in New Zealand have access to free prescriptions and doctor appointments, with costs sometimes occurring at after-hour clinics.

Talemaitoga says the barriers actually come from the GPs themselves, and the need for them to build strong relationships with the child's parents.

"The basic thing is the quality of the interaction, it’s not a transaction, it’s not a come in, show me your throat, take these antibiotics, see you later. It’s about empathy and understanding the parents. ​

"Do you understand their living conditions? forty per cent of Pacific families live in overcrowded households. They’re running twenty minutes late, but do you understand that mum would’ve wanted to be there on time but the car wasn’t available because another family member was using it.​​ We need to show our care to the parents and wider whanau." ​​​​

This is the "outside the box" thinking Jeffreys is calling on the Ministry of Health to think about when it comes to delivering primary healthcare to Pasifika and Maori.

"We need to think about bringing the service to families rather than relying on families to the service. That might mean more outreach services, that might mean extended hour services, that might mean for example providing taxi chits for people to get to a GP.​"

But Talemaitoga says realistically the workforce is too "stretched" to be bringing services to families. Instead he calls on GPs to be more flexible.

He says: "Sometimes parents feel like doctors tell them off for wasting their time. If they had a ten o'clock appointment and they arrive ten minutes late, I’ve known of some clinics that say sorry you need to make another appointment.

"It’s easier for me to have it done in a clinic setting, but that clinic needs to be responsive to the lifestyle that the parents lead but that only comes when you have a good relationship."​

Talemaitoga says good primary health care treatment and preventative measures will improve long-existing illnesses children face.

"Respiratory illness in children are one of the highest rates of admission to hospital and I believe primary care can make a huge dent to stop that in the community, if we don’t we will have all these high rates of admission to hospital for our children, which leads to missing school for them, and mum or dad missing work to be with their child."

He says at the end of the day his job as a clinician is to support parents and give advice on how they can better support their child. 

Doctor Api Talemaitoga (L) & Doctor Mona Jeffreys (R).