Proposed health centre X-ray facility under spotlight
The existing X-ray room at the Golden Bay Medical Centre. Photo: Gerard Hindmarsh.
The plans for the new Integrated Family Health Centre (IFHC) are in the spotlight as questions are being raised about the proposed X-ray service for the Bay.
The original plans, as drawn by designer Andy Clark in September 2010, show a 14.2 square metre X-ray room, but the most recent drawings by Auckland-based architects Peddle Thorp show no dedicated X-ray room at all.
IMG spokesperson Linda Sanders explains: “The removal of a dedicated X-ray room was one of the changes suggested by the Clinical Leadership Group, which has spent many days in specialist teams doing detailed planning of every room and space in the new facility. The new X-ray machine will be portable and needs minimal space – hence there’s no need for a dedicated room. Typically this type of machine is attached to a laptop, and from there the digital images are able to be read at any location on the network, including by reviewers out of the Bay who can provide advice to our GPs. We believe that the new X-ray machine will be an upgrade for the Bay in terms of the quality of the image.”
The existing X-ray machine will not be moved from the medical centre to the new facility because technology has moved on and it cannot provide images of sufficient quality, says Linda Sanders.
But Victoria Davis, an ex-radiographer for the GB Medical Centre (GBMC), says that moving to a portable machine will be a big downgrade for the Bay.
“Golden Bay has an increasingly older population, real people who require hips and spines and backs to be X-rayed. All those people will have to go over the Hill now because portable machines can only do legs and arms. The full-body-capable machine at the medical centre is not out of date, fragile or cumbersome. Sure, it’s been around for a while, but low usage has meant minimal wear and it’s got a lot of life left in it yet. The movable table-top is a great asset because it allows great imaging capability and ease of patient positioning. All the equipment has to be calibrated annually and has passed all inspections.”
Victoria was one of two part-time radiographers employed by the GBMC. She resigned last year after 23 years, and Joan Butts job shared with her between 1990 and 1999. Since Victoria’s departure, the GBMC has been mostly reliant on two of its own doctors (Drs Russell and Clark) who have limited licences to take X-rays of arms and legs, but not torso or heads.
Says Dr Iain Russell: “Basically, we save up all the hips, spines and backs and get a radiographer in from over the Hill – not much has changed because the complex stuff always went over there anyway. One major upgrade only happened last week with the installation of a new digital reader, which takes away the need for chemical film technology. We still have to learn the enhancement techniques, but that’s a great step forward.”
Digital recording does not translate to higher-resolution X-rays, but it increases possibilities for enhancement.
Without a doubt, getting radiographers in from over the Hill is an expensive business, but there isn’t enough work in the Bay to make a full-time position worthwhile. Presumably, removing the need for a full-body-capable machine at the IFHC would subsequently reduce that cost by allowing our GPs to perform most of the X-rays. Linda Sanders says this is in line with what other medical centres around the country are doing.
The historical reality is that Golden Bay has long been out of the mould when it comes to X-ray services. Notably, it was the first place in Nelson Province to get an X-ray machine, in the mid 1930s when Takaka GP Dr Edward Bydder brought one back from a trip to Italy and installed it at his private hospital on Commercial St (now the Shady Rest).
When Golden Bay’s medical practitioners found themselves without an operable machine in the late 1970s, an agreement was made with the Vet Club to use their veterinary machine, mainly for ACC, limb-type injuries.
Around 1983, Nelson Radiology installed the current machine at the GBMC, with Golden Bay residents donating the room extension for it. When Nelson Radiology withdrew in 2000, it was purchased by the GBMC Community Trust and operated within the business structure of the then GBMC (four doctors’ individual businesses sharing expenses) until Nelson Bays Primary Health bought the doctors’ practices last year.
That purchase did not extend to the X-ray service here.
Who will own and maintain the IFHC’s new X-ray equipment is a question that could also be extended to all equipment and chattels there as well.
Says Linda Sanders: “Exactly who will own the assets will all be part of the lease agreement when it’s done, but the understanding we are operating on is that the trust will own the building and fixtures, while the Nelson Bays Primary Health will own the medical equipment. Our plan is to establish a register of assets that have been donated by the community, like the new hoist, so that their ownership is enshrined as such.”
Comments Victoria: “However it’s put, it does appear our radiographic capabilities and services are going to be reduced, with no designated place to house or operate the new portable machine. Golden Bay can be proud of our past X-ray service, which has saved many a painful ride to the nearest X-ray at Nelson Hospital.”
Gerard Hindmarsh
