Health providers hear from a woman in Christchurch Women's Prison about the challenges accessing health services in the community. (Image taken Nov 2020)A partnership between Canterbury Health providers, social agencies and Ara Poutama Aotearoa has resulted in Te Whatu Ora - Health New Zealand​ Waitaha Canterbury (formerly the CDHB) funding three free GP visits for all people leaving prisons into the Canterbury District. The programme includes an extended first consult with a GP, and includes people who have been in prison on remand or returning from Australia to Canterbury on a Section 501 order.

The programme, named Te Ara Whakapuāwai, aims to address obstacles of enrolment, cost, discomfort and potential whakamā (embarrassment or shame) which can be barriers to engagement with GP services. Previously available only for people who have served a prison sentence of more than two years and for Australian returnees, the extension of this initiative will support a much larger group of people into community-based health care.

“We know that people in our services are amongst the least health-connected in our community,” says Southern Region Operations Director Health, Jill Thomson. “Te Ara Whakapuāwai will encourage and support prison leavers to maintain the health gains they have made in prison and, most importantly, to continue to access their essential medications and further mental and physical health care.”

People will be able to access a voucher for the service through their Probation Officer, Case Manager, the Court team or prison health services and, while people don’t need a voucher to access the service, the group believe having this will increase people’s comfort and reduce any concerns they may have about difficult conversations or unexpected charges at the medical service.

“Most people will have a probation officer and will be provided with information and a voucher at their first meeting,” says Jill. “For people leaving prison without the need for Community Corrections services, a voucher will be issued at, or just prior, to release by prison staff connecting with our community team.”

The Canterbury Clinical Network (CCN) Coordinated Access on Release Group, which is behind the initiative, has been meeting for several years and is made up of representatives of health and social services from across Canterbury. These include Te Whatu Ora - Health New Zealand​ Waitaha Canterbury, Christchurch Primary Health Organisation (PHO), Pegasus Health, Waitaha Primary Health, He Waka Tapu, ACC, MSD, Laura Fergusson Trust, and other community health organisations.

“The organisations in this group all have a goal to improve health equity and outcomes in the community, and this has led to us exploring a wide range of initiatives including eradicating Hep C in prisons, improving ACC reporting and referrals,” says Jill.

“The group recognises that the challenges to health services often begin before the person reaches a GP. Many GP practices are full, some people we work with will have challenges accessing GP services, or may have burned bridges with their GP through previous behaviour, including bad debts. People having difficulty finding a GP can be helped to enrol through the Partnership Community Workers (PCWs) service.”

Laila Cooper, Acting Chair of the Coordinated Access on Release Working Group, welcomes the introduction of the revamped Te Ara Whakapuāwai service. She says it has been very encouraging to work with colleagues from other sectors to develop this initiative designed to help address gaps in the health system for this population.

“I have been impressed by the dedication and commitment of the Working Group members to work collaboratively and problem solve, and hope that this will be an ongoing process,” says Laila.