Good care closer to home!

Monday, February 10th, 2020 | Rory | 2 Comments

Blattner K, Stokes T, Rogers-Koroheke M, Nixon G, and Dovey S. Good care close to home: local health professional perspectives on how a rural hospital can contribute to the healthcare of its community. New Zealand Medical Journal. Vol 133 No 1509: 7 Feb 2020 Link – NZMJ articles are open-access 6 months after publication

This paper from Kati illustrates the unique and special place that Hauora Hokianga has within NZ medical system. The four main themes: “Out context”, “Continuity of care”, “Navigation”, and “Home” encapsulate how many of us would like to view our health services.

Tino pai Kati

“Yes—observation. The medical intervention is quite a small part of medical treatment, isn’t it, often? It’s about being able to observe, have a place of safety, and have a place of recovery as well.”



Hokianga Health in New Zealand’s far north is an established health service with a small rural hospital, serving a largely Māori community. The aim of this study was to gain insights into the wider roles of one rural hospital from the perspective of its staff.


Eleven face-to-face semi-structured interviews were conducted with employees of Hokianga Health, eight with past and current medical practitioners, three with senior non-medical staff. Interviews were recorded and transcribed. Thematic analysis of the interviews was undertaken using the Framework Method.


Four main themes were identified: ‘Our Context’, emphasising geographical isolation; ‘Continuity of Care’, illustrating the role of the hospital across the primary-secondary interface; ‘Navigation’ of health services within and beyond Hokianga; and the concept of hospital as ‘Home’.


Findings highlight the importance of geographically appropriate, as well as culturally appropriate, health services. A hospital as part of a rural health service can enhance comprehensive and continuous care for a rural community. Study findings suggest rural hospitals should be viewed and valued as their own distinct entity rather than small-scale versions of larger urban hospitals.

Kati also pointed me toward this article from this article by Glen Colquhoun. In it he describes a country of many Hauora Hokianga’s.

“The role of a health system is not to bounce patients away from it. It is to help, to open its arms and surround with care. It is to be the embodiment of nurturing – our mother’s wide open arms.”