Health system reforms: Grieving families speak out on end of ‘postcode lottery’ care

A grieving widow whose dying husband was told to wait eight weeks for an “urgent” specialist assessment says she will grow old alone and her children are without a father.

The wife of Blair Vining – who became the face of New Zealand’s “shocking” postcode lottery care – spoke yesterday after the Government unveiled the biggest overhaul of the country’s health system.

“Life without Blair is indescribable,” Melissa Vining told the Herald.

“I will grow old alone without my soulmate, we are all lucky to have had Blair in our lives and even though the pain is huge we all still feel lucky to have been loved by him, he was an exceptional human.”

Every day at least one New Zealander dies due to inequitable healthcare based on their age, income or where they live.

Announcing the major health system shake-up, Health Minister Andrew Little said the changes were designed to end postcode lottery care – which means the quality of treatment can be affected by where you live.

All of the country’s 20 district health boards will be replaced by one national body and a commissioner appointed for each region to keep regional priorities in focus.

A new Māori Health authority will also be established, with the power to commission health services and monitor Māori health, as well as developing policy.

The Herald spoke to grieving families who have been left wondering if their loved ones might still be here if they lived elsewhere.

When New Zealand lost Invercargill cancer patient Blair Vining there was anger in the air.

The 39-year-old, with the support of his family, dedicated his final months to fighting for better cancer care across New Zealand.

After being given a terminal diagnosis, Vining was told to wait eight weeks for an “urgent appointment” with an oncologist.

His wife Melissa refused to let her husband die waiting and called every person she could think of until she got hold of the medical director of New Zealand’s Cancer Society and top oncologist Chris Jackson.

As a result, Blair was able to start chemotherapy right away and was put on the best treatment possible – giving him enough time to renew his wedding vows and savour the time he had left with his two teenage daughters.

But there was one itch he couldn’t let go – the country’s “broken health system”.

A Herald investigation revealed that cancer care waiting times between DHBs varied significantly with some experiencing delays of up to six months.

Vining – dubbed a legend, a hero and inspiration to many – died in October 2019.

Melissa Vining said the couple’s “beautiful girls” still missed their amazing dad.

She continues to fight her late husbands cause and bring hope to others with the launch of a Southland charity hospital.

Emerald Tai, 27, died with her baby son Tanatui Samuels three days after giving birth.

She left behind six children, her partner also named Tanatui Samuels, and mother Susan Fa’amoe.

The newborn and mum were found unresponsive in bed at their West Auckland home on March 16 last year.

An investigation revealed a number of gaps in the system that enabled the new mum to self-discharge with “early indications” of an infection to an address not listed with health-care providers.

The tragedy sparked a raft of changes to maternity care at Auckland District Health Board.

The family told the Herald they can’t help wonder if she might still be alive if she had received different care somewhere else.

Fa’amoe said: “Emerald was a wonderful person, she had a good life and she really did have a lot to live for – she had a long life ahead of her.

“She was such a joyful person and it was a blessing to have her in our lives.”

She revealed she never had the chance to meet her grandson, and the only photo she has of him is when he was lying in a casket with his mother.

Whangārei woman Ruby Hill died at age 23 after being told her illness was in her head and she “just needed to eat more”.

Everyday Ruby was told how great she looked because she’d lost so much weight – yet she was dying of a rare illness called gastroparesis – where the stomach is unable to empty itself of food properly.

Since losing her only daughter, Ruby’s mum Jo Hill has been fighting to help others with the same crippling condition.

“Gastroparesis sufferers are fading due to postcode lottery and the limited specialists in the field with knowledge of the condition.”

Ruby had to travel 158km for specialised care.

In the three years prior to her death, in May 2019, she struggled to get food down without throwing up and in her last month weighed just 22kg.

Her final years were agony – in severe pain, vomiting and rejecting everything that got ingested whether it was solid or fluid, small or large.

Jo Hill described Ruby as a “beautiful soul” who despite everything was forever smiling.

While her daughter could not be saved, Hill hoped the new system would help put a stop to “professional bias” and cruel inequities.

Keith Marshall was 58 when he was diagnosed with colorectal cancer – two years shy of the national screening age for bowel cancer.

He died in March last year.

In his final call for change before his death, the Māori patient backed calls for the Government to screen patients earlier.

The father of two and granddad of four had been in and out of hospital for treatment ever since, but in January last year things took a turn.

“20th of January [2020], I was admitted to Masterton Hospital and everything started to go bad

through the cancer returning, and it came back the second time as being terminal and stage four, it grew on my spine and I’ve lost the use of my legs,” he said.

Marshall said while it was too late for patients like him, the Government could still do the right thing.

“The point I’m trying to make is that if it could be caught a lot earlier, it would be fantastic, for Māori in particular.

“Lower it as much as you can, save as many people as you can.”

More than 1000 New Zealanders die from bowel cancer every year, and over 3000 are diagnosed.

Top oncologist Chris Jackson said this new health system would help save lives and put an end to the postcode lottery.

“We have been calling for this for years and finally it’s here,” Jackson said.

But “we should not underestimate the task”.

“Having worked at a DHB that was amalgamated with its neighbour that’s a very difficult logistic process and to amalgamate all of the DHBs into one unified [organisation] – everything is a bigger task than it sounds at first glance.”

Whangārei nurse Terryann Clark said she was “incredibly hopeful” this new health shake-up will fix deadly failures in mental health.

Clark, who is also an associate professor at the University of Auckland and was involved in the Youth19 research, was critical of the current system, saying there was too much variability and health agencies weren’t being held to account.

“We have 20 different DHBs with 20 different rules … there’s been no national standard of care.”

She said she could think of lots of examples of parents trying to get their children help and because they weren’t “critical enough” they get bumped down the list and then it becomes too late.

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