Relentless pressure: General practice under strain and 'could collapse'

Author: Maryana Garcia,
Publish Date: Thu, 8 Dec 2022, 2:27pm

��General practices could collapse under “relentless” pressure, Bay of Plenty GPs say.

The comments come as an association representing about 400 general practices launches a nationwide campaign to “save your family doctor service”.

General Practice Owners Association of Aotearoa New Zealand (GenPro) launched a #saveyourfamilydoctorservice campaign last month

The campaign comes after the publication of Te Whatu Ora’s annual New Zealand Health survey results revealed 11.7 per cent of adults in New Zealand or an estimated 478,000 people reported not seeing their GP due to wait times in the past 12 months.

A further 10.7 per cent of adults reported not seeing a GP due to cost in the year 2021/2022.

Rotorua’s Tiaho Medical Centre practice nurse manager Tracey Morgan. Photo / Andrew Warner

Last month, Minister of Health Andrew Little announced ongoing funding of $200 million to tackle pay parity in the health sector, a decision that did not include nurses working in GP practices.

��“I have to be clear that this package will not mean significant change immediately for those working in GP practices,” Little said in his announcement.

In Rotorua, Tiaho Medical Centre practice nurse manager Tracey Morgan said when Little’s announcement was made the news was “hard to take”.

“A majority of GP practices would love to pay their nurses parity but they can’t and I’m seeing it.”

Morgan said she knew of at least one nurse who had resigned after hearing the Government’s pay parity funding would not apply to general practices.

“This is not just about money or pay parity,” Morgan said.

��“It’s about equity and resources and caring for our nurses, caring for our patients.

“Everyone thinks nurses just put plasters on but there’s much more to our work than that.”

Health Minister Andrew Little. Photo / File

Mount Medical Centre GP Dr James Peckett said GenPro’s campaign was important to bring home to New Zealanders that general practice was under a lot of strain “and could collapse”.

“General practices are pretty much private businesses that are subsidised through the Ministry of Health,” Peckett said.

“Because of that we are constrained as to how much we can charge and we still need to pay our staff at market rates.

“A really hard thing for us is we are competing with Te Whatu Ora and the nurses in the hospital get paid more and we find that’s very unfair because they’re both of the same value.”

Peckett said the Government only allowed general practices to increase fees by 2.38 per cent in 2022, a number which did not cover increasing costs due to inflation.

“We can’t run at a loss,” Peckett said.

“We’ve had to close our books. We reduce the number of hours we are open. We no longer provide after-hours services and we have increased pay to retain our employees.”

Western Bay of Plenty Public Health Organisation clinical adviser and Mount Medical Centre GP Dr James Peckett. Photo / Supplied

Peckett said an increase in funding in the short term would allow general practices to advertise better pay rates to attract more staff.

“If we had more staff we would be able to service our population better and have a more stable workforce. If we knew we were getting more funding we could plan ahead.”

In the meantime, Peckett said patients could support general practices by signing GenPro’s petition calling for “swift and decisive action” or risk the loss of more essential doctor services across the country.

“In terms of accessing medical care [patients will need to] hope for the best and take what is on offer for now.”

Edgecumbe’s Riverslea Medical Centre GP Dr Cecile de Groot said the Government’s decision to exclude GP practices from pay parity funding was “a kick in the guts” for a sector under “relentless” pressure.

“General practice nurses need to be highly skilled and experienced. They do everything and they do not get a break during the day.

“We are the first port of call. If we aren’t there the ED can’t replace us.”

De Groot said people needed to have confidence that they could access medical care when they needed it and where they needed it but in the current situation, she was being forced to tell patients to wait.

“It’s frustrating because by the time I see people their condition is worse.”

GenPro was founded in 2020 by general practice owners concerned about the industry’s lack of resources to negotiate with the Government for funding and support.

GenPro chairman Dr Tim Malloy. Photo / ��һ�ǿ��

GenPro chairman Dr Tim Malloy said the association decided to “go public” with their campaign due to serious concerns about the risk to public health.

“We’ve tried bureaucracy and achieved nothing,” Malloy said.

“We feel we must warn the public that there is an uneven distribution of health care and it is only going to get worse.”

Malloy said implementing the nine-point programme proposed by GenPro would at least allow the sector to retain its current workforce. He said the exclusion of GP practice nurses from Little’s announcement was, in his opinion, “disappointing and insulting”.

“If we continue as we are, we’re going to lose 40 per cent of the GP workforce continuously over the next five years. It just breaks your heart.”

Health Minister Andrew Little said he met with GPs from all over the country regularly and was “well aware” of the issues they face.

“Years of under-investment, an out-of-date funding system, the impact of the Covid-19 pandemic and the worst flu season anyone can remember got us to this position,” Little told ��һ�ǿ��.

With regards to pay parity for general practices, Little said the fund was not closed to GP practices.

“But we need to see evidence that there actually is a pay difference.

“The information supplied to me shows that many nurses in GP practices are getting paid nearly as much as nurses in hospitals.”

Little said over the past 10 years, including 2022, annual adjustments to funding have included inflation.

“Budget 2022 includes $86m over four years to more equitably allocate primary care funding to general practices based on their high-needs population.

“Distribution of this additional funding will begin in 2023.”

GenPro’s 9-Point Plan for sustainable family doctors services: