Rural health: a case study of the Dannevirke community hospital: an exemplar of innovation

Abstract

Rural communities can take pride in the way they have grasped opportunities to develop innovative health services at a time when the Crown is requiring relevant, responsive and affordable services. This report begins with an outline of Government's rural health policy. The basis for developing the policy was the Crown's acknowledgment that it could no longer afford to provide health services without being able to limit liability. Open-ended, demand driven reimbursement regimes were incompatible with government's need to constrain expenditure and focus on health outcomes. Rural health service costs were increasing disproportionately to any population growth or improvement in health status. The report tells the story of the Dannevirke health service which has been transformed from a 180 bed public hospital in its hey day, to a 9 bed rural health centre and an array of community services. The range of partnerships - the community with: MidCentral Health Ltd, health professionals in private practice, community trusts and other organisations - has resulted in a unique service which meets health needs in a way that is acceptable to the community and to the funder, the Health Funding Authority. The report describes the Crown Health Enterprise's exiting process, the community responses and the new service that emerged after extensive consultation. The report concludes with comment on key issues essential for ongoing viability of the service.