Nau mai, haere mai,

In 1987, my mother was hired as the charge nurse for the children’s ward at Dargaville hospital. We migrated from Johannesburg to the small town in Northland and entered a wildly different world (one I am forever grateful for).

But in a few short years, that ward was closed. Services at the rural hospital have since been peeled back, leaving the community to drive 55 minutes to Whangārei Hospital to access acute care.

For those who have been watching – and worrying – about the state of rural healthcare, it was little surprise there was no doctor at Dargaville Hospital recently when someone went into cardiac arrest. A nurse was left trying to work with a doctor over video link to save the patient.

Policymakers have lauded “telehealth” – doctor appointments delivered over the phone or via online platforms – as a way to expand health services to the 900,000 New Zealanders living in rural regions.

But as Kyle Eggleton writes, there are negatives to this approach.

Eggleton’s own research has found telehealth can disrupt an important element of health services: continuity of care.

As he explains, “Continuity of care, in which a patient has an long-term relationship with a single doctor, has been shown to lower mortality. The reduction in mortality due to continuity of care is 8% after two to three years and 25% after 15 years.”

This is a significant reduction in mortality rates and highlights just how important the role of a local doctor can be – particularly for rural communities who are dying at higher rates than their urban counterparts.

So yes, telehealth can help. But it can’t be a replacement for greater investment and an increase in rural doctors. As the government considers how to manage the health sector worker crisis, it needs to consider long-term solutions that will deliver quality heathcare to all New Zealanders.