A world-first South Auckland dialysis model is being praised for saving lives, restoring dignity, and easing pressure on Middlemore Hospital, but its future growth depends on Government backing.
More than 235 South Aucklanders have already been helped by dialysing close to home instead of travelling to hospital.
The Kidney Society’s three community dialysis houses have proved so successful that Te Whatu Ora is considering opening a fourth.
But the number needing help is expected to grow, with the dialysis population forecast to increase by about 30% in the next decade.
The three Kidney Society facilities, run in partnership with Te Whatu Ora Counties Manukau, allow trained patients to manage their own dialysis at flexible hours, typically three to five times a week.
Dr Chris Hood, clinical director of medicine at Te Whatu Ora Counties Manukau, said the facilities were meeting current demand but would soon need to expand.
“They’re not full. They’re filling up. So we’re thinking about getting a fourth.”
Last month, The Kidney Society hosted a community celebration marking 21 years of its dialysis houses.
Savele “Fitz” Refiti, who begun dialysis in 2014, said the flexible hours changed his life.
“With these houses you get flexibility… you could come at midnight or 10 o’clock… and then in the morning you can go to work,” he said. “It just feels homelier than a hospital.”
Hood said the houses were designed for patients who could safely manage treatment after a short training period.
“It takes somewhere between eight and 12 weeks to train somebody to do their dialysis,” he said. “Which is about 10 to 15%of all dialysis patients at most.”
South Auckland is the only region with three dedicated community houses run in partnership with Te Whatu Ora.
“Hospitals can’t really do that… but if we team up with a charity, then the charity might be able to provide the facility.”
“This was a world first when it happened,” Hood said of the model’s success.
The first community dialysis house opened in Papatoetoe in 2004, becoming the first renal facility in the country to operate without medical staff present.
Two more houses followed in Māngere East, giving South Auckland a total of 28 dialysis chairs serving up to 55 people.
Kath Eastwood, chief executive of The Kidney Society, said the houses were built on a simple belief.
“We’ve always believed that home is best for people who can dialyse independently.
She said community dialysis costed roughly half as much as hospital treatment and delivered better outcomes.
“People have much better outcomes when they have the flexibility to dialyse when they want.”
The model was particularly valuable for Māori and Pacific patients who often face barriers such as housing insecurity and travel costs.
“Our dialysis population is forecast to grow about 30% in the next decade,” she said. “Establishing more of them will require more local and central government support.”
Lou, whose father dialyses at one of the Māngere East houses, said the journey tested their family.
“His biggest fear in training was needles… With encouragement and support, Dad was able to go through it.”
She valued the safety of the homes, saying, “If anything happens, you just press the button and someone responds”.
Chantelle Good, chair of The Kidney Society, said the partnership with Te Whatu Ora had delivered proven results.
“[We’ve] saved the taxpayer about $92 million by being able to dialyse in the houses rather than the hospital because we do it a lot cheaper than the hospital does.”
She said Māori and Pacific people made up a significant share of those receiving dialysis.
“I think it’s about 50% to 60%, a high percentage of dialysis patients that are Māori and Pasifika.”
According to Kidney Society figures, community dialysis saved the health system an estimated $130 million since 2004.
Good said the next goal was a fourth facility in Counties Manukau to meet growing demand.
“If you empower communities, they can solve their own problems. The Kidney Society has always been about that.
“We walk alongside people and really enable them to live their best lives. What we want is support to be able to establish more houses like this in other parts of the country.”
– LDR is local democracy reported co-funded by RNZ and NZ On Air
