21 Nov 2022

GPs write open letter to Health Minister seeking urgent fix for family doctor services

1:16 pm on 21 November 2022
Unknown woman-doctor typing on laptop computer while sitting at the table in sunny clinic.

The open letter to Health Minister Andrew Little described general practice services as "stretched and under threat". Photo: 123rf

GPs have written an open letter to the Health Minister calling for immediate action to fix front-line family doctor services.

It is part of a campaign by the General Practice Owners' Association (GenPro) whose members include more than 400 general practices and urgent care providers to address staff shortages and underfunding.

GenPro chair Dr Tim Malloy said a lack of funding, workforce shortages and increasing demands were placing essential family doctor services at risk.

It put pressure on the rest of the health system and directly impacted patient's health, he said.

"It means in lots of places around New Zealand people are waiting weeks to see their family doctor, as general practice clinics are reducing their hours and reducing services," Dr Malloy said in a statement.

The campaign includes billboards and a report called "On The Brink" which sets out a nine-point plan on boosting support of GP services.

People are also being asked to send postcards to the minister and to sign a petition.

Malloy said a 3 percent funding increase in July with inflation at more than 7 percent and rising living costs had been a massive blow to general practice.

That equated "to a real-terms funding cut" on 1 July, Malloy said.

"Our essential local nurses and doctors have been undervalued and underappreciated. They have had enough, and patients are at risk as we face an unprecedented exodus from the service."

General practice had struggled with historic underfunding and now doctors and nurses did not want to work there and were better paid if they opted to work in public hospitals or in Australia, he said.

The government was investing billions in health bureaucracy but had lost its focus on essential front-line services, Malloy said.

The open letter to Health Minister Andrew Little described general practice services as "stretched and under threat".

It called for immediate action from the government to address the crisis and to work to develop a clear plan for the future of family doctor services.

A 2020 survey found that 58 percent of GPs planned to retire in the next 10 years and Dr Malloy said it was very concerning there was no plan in place to replace them.

"If you don't invest in supporting both the workforce and the resourcing of that service then you pay for it somewhere else," he told Morning Report. The reality is we are already paying for it in presentations to EDs pressures on our hospital services our specialist services are overwhelmed."

Australia had more GPs relative to the population and practices were better resourced "so it becomes a very attractive career option somewhere else".

GP nurses were being paid on average $8000 less per year than public hospital nurses and bringing them to the same level would be "a very good start".

Covid-19 had unmasked the inadequacy but the cause now was the burden of disease, the aging workforce, the lack of previously training sufficient numbers, he said.

Government is addressing longstanding problems - Health Minister

Health Minister Andrew Little said the problem had been a long time in the making and this government was addressing them.

"The sorts of things we are doing didn't happen 10, 15, 20 or more years ago, is part of the reason for the problem," he told Midday Report.

"We have to start somewhere, we are starting."

The government had worked to increase the numbers of GPs being trained from 200 to 300 a year and increase the pay for trainees. On immigration, 65 GPs had been approved and had got visas.

There did need to be improvement in certification of overseas doctors so it was as swift as possible, but most other proposals from GenPro would take time to implement, he said.

Pay parity had been a key focus of his work, Little said, however problems were found in GenPro's data supporting its argument, and he had asked the organisation for further information but had not received anything from them.

Little "totally disagreed" that funding was going into new health system reforms at the expense of front line services. He said saying extra money was going into front line health care including $100m to primary services alone.

The general manager of Three Rivers Medical Centre in Gisborne which has nearly 20,000 enrolled patients, half of them Māori, said it was unacceptable that doctors were being forced to provide services to vulnerable populations "on the smell of an oily rag".

Michelle Te Kira said there were challenges due to underfunding and gaps in the general practice model.

"The methodology used to allocate funding is flawed and confusing, and we are being presented with more complex patient needs that cannot be solved in a 15-minute appointment model," she said in a statement.

It was critical to be well-funded and to have appropriate numbers of family doctors to be able to provide adequate safe services and high quality primary health care, she said.

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