Kerre Woodham: Family doctors have gone the way of the moa

I did want to have a look at the state of our primary healthcare – this is something we've looked at before, and I have absolutely no doubt that we will look at again. I do tend to agree with the GP advocacy group, General Practitioners Aotearoa, that the concept of the family doctor is dead. You're not going to get a Dr Finlay's Casebook again any time soon on the telly. You're not going to see a doctor who has not only looked after your primary health for much of your life, but also that of your family’s. These are the kinds of doctors that have gone the way of the moa.  

Where I would disagree with the GPA is that they said you wouldn't see the sort of queues for GPs that we saw in South Auckland, in Remuera. I would argue it's just as difficult for people in the blue chip suburbs to get in to see a GP as it is in the poorer areas. It's just the people with disposable incomes can have other options.  

A briefing given to Dr Shane Reti when he took over as Health Minister warned that New Zealand is at least 485 GPs short across the country. Remember trying to find the GP in Tokoroa? A GP was looking for somebody to take over the practice - all sorts of offers were put out there, nobody was interested. This number’s expected to grow to a shortage of between 750 and 1050 doctors in the next ten years. At least a quarter of a million Kiwis aren't enrolled with a practice. Many of them won't take on any new patients. 1,034,000 people said they struggled to access GP services because of cost in 2022/23, double the number of the previous year. And the impact of this of course is pressure on hospitals, emergency departments, specialist consultations and immunisation rates. Waiheke Island’s only afterhours medical clinic closed its doors yesterday; 24 practices and clinics in Canterbury, the Southern Region, Hawke’s Bay, and mid Central that provide after hours or urgent care experienced closures or reductions in hours in 2023 because there aren't enough GPs.  

There is a tiny bit of good news... in March, the Health Minister pointed to work beginning on setting up a third medical school and record numbers of GP registrars as green shoot, but added, “I understand there are other parts of retention and remuneration we need to collaborate on.”  

There is so much need everywhere, across every field, but GPs are in crisis. If a crisis can be something that continues for many, many years, because they have been saying for at least the past five years that they are struggling. Pre-Covid they were struggling. GPs were getting older, new doctors weren't training in the field, they were getting stressed and burnt out because they were seeing so many patients with so much need, and yet without them, they are such an important component of the country's overall health plan that you cannot have a healthy country without healthy GPs. Difficulty in accessing GPs results in pressure on EDs and poorer health outcomes once people do finally get treatment.  

I've been with the same GP practice for about 25 years. I don't see the same GP; I've had a succession of really lovely, fabulous GPs come and go. The last one I was absolutely fabulous, but she now only works mornings because she's trying to manage herself, and her family, and her practice, and it's all just overwhelming. It was three weeks before I could get in to see a GP. You expect to have to wait. If it's urgent, they do their best. If it's urgent, you try and get into an afterhours clinic, but you have to have the money to pay and there has to be an afterhours clinic open near you.  

So like I say, difficulty in accessing GPs no matter where you are in the country, but if you have money, if you have disposable income, you can get a result a lot more easily. Do we try and attract them from overseas? Do we try and attract young people, pay their student loans if they become a GP?  We've seen what happens when you try and attract somebody with money and all the add-ons and the bells and whistles to get to Tokoroa.  If they don't want to, they don't want to. Have the days of the family doctor gone the way of the moa? We just have to adapt to a new way, a new style of doing things.   

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