A rash of winter ills is coinciding with a drastic shortage of doctors in New Zealand - but there's far more wrong with general practice than that
Photo: Photo /123RF
A mass exodus of staff, the ones who are left vastly overworked, disappearing doctors, swathes of scathing reviews.
Lower Hutt's High Street Health Hub may be an extreme case, sparking claims its corporate owner cares more about money than people, but it's part of a much larger picture of GP clinics under stress in New Zealand.
Delays in getting appointments, sometimes of a month or more; a funding model that's described as not fit for purpose; runaway fees and costs; and disappearing doctors are all part and parcel now of primary health care.
Today on The Detail we look at the Lower Hutt situation, and at the wider issues surrounding the sector.
Dr Bryan Betty is a specialist GP in Porirua Photo: RNZ / Karen Brown
Dr Bryan Betty is a specialist GP in Porirua, and the chair of General Practice New Zealand. He has real concerns that with the government's latest funding offer, some practices may not be viable anymore. He says they're already starting to close.
Primary Health Organisations have rejected Te Whatu Ora's four percent increase to core general practice funding and say they will have no choice but to pass on costs to patients. The government is enabling that by increasing the amount they can charge clients by 7.76 percent.
The funding system in New Zealand is a mixed model, with a fee given per patient who signs up to a practice, which is topped off with a co-payment from the patient.
The government's latest offer for this year's increase averages out to a 5.58 percent, but Betty says rising costs and chronic underfunding of the past mean that's not nearly enough.
RNZ reporter Kate Green has investigating a practice run by Green Cross Health that had to stop face to face consultations because it had just one doctor. Photo: RNZ / Samuel Rillstone
"We presently estimate there's an underlying funding deficit of about 14 percent that's built up over the last 10 years. So there's real concerns over the offer that was made."
He says many practices are operating at very thin margins, or at a loss.
But the basic issue across the country is one of capacity, with about half of practices with closed books and not accepting new patients.
"At the moment it's estimated we're short of three to four hundred GPs across New Zealand," Betty says.
"We should be training 300 specialist GPs a year. We've been doing around 200 - this year is slightly higher at 230 - so we're way below what we should be training, and we do have a shortage."
He points out that puts huge pressure on after hours emergency departments and hospitals as patients seek help elsewhere, presenting a real issue for the New Zealand health system.
The Detail also talks to RNZ reporter Kate Green who has been covering the Lower Hutt story, where a practice run by Green Cross Health was forced to stop face to face consultations for most of its nine thousand patients, because it had just one doctor. It now has two, but most consultations are still done remotely by telephone.
"Green Cross have basically said it's so hard to recruit - and that is true," she says.
"This is not just a problem that is faced by Green Cross or even just Lower Hutt - this is a nationwide problem, we know there are not enough staff and people are really struggling to get appointments, or even just enrol in a doctor all over New Zealand."
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