That means only Rarotonga and Aitutaki get doctors; other islands will only have nurse practitioners, flying doctor services and, in emergencies, the option of evacuating critically-ill or injured patients to Rarotonga.
Samuela George, former mayor of Mauke Island, said the ministry needed to visit the Pa Enua to see the problems the island people are facing.
Mauke needs at least one doctor, he said. “We are not worried about the nurse practitioner, at least we got something, but what we would prefer is to have a doctor.
“They have to be here to see what it is like, what the people are feeling and facing. People have confidence when seeing a doctor.”
In emergencies like risky child-birth, a plane could take pregnant women to Rarotonga and back. But George said that money would be better spent on having a doctor on the island.
Qualified Cook Islands doctors have said they would like to serve their communities in the Pa Enua, but government does not pay doctors enough even to cover their student loands.
Mangaia has been without a doctor since 2014; last week a seriously ill woman and three other patients had to be flown to Rarotonga in a charter flight.
The ministry said it had developed the flying doctors and dentists programme into an integrated, structured, and comprehensive mobile health service, the Kaveinga Ora programme.
Nurse practitioners were leading health services delivery on the smaller islands, aided by the regular doctor visits.
“Nurses are the backbone of our health system,” said Health Secretary Dr Josephine Herman. “We appreciate and value the resilience of our nurse practitioners and nurses, as well as our clinical support and general support staff, who work in such remote and challenging settings.”
Furthermore, she said that the Pa Enua nurse practitioners practise with clinical oversight provided by doctors and senior nurses.
She said that improved technology through phone and internet (email/electronic patient medical records) helps connect our Pa Enua workforce with Rarotonga so that nurse practitioners can access clinical advice from the lead doctors of the various speciality areas.
According to the ministry the Kaveinga Ora Team comprises of doctors, dentists, nurses, health protection and health promotion officers and public health nurses.
Dr Herman said: “Health security and border health services are key to protecting our Pa Enua populations from threats such as dengue and flu… We are working hard to ensure our people have access to safe and quality drinking water and sanitation.”
Meanwhile in terms of patient referrals from the outer islands, director hospital services, Dr Yin Yin May says the ministry of health runs an efficient service when it comes to patient referrals from the Pa Enua to Rarotonga.