Opinion: GPs shortage – new solutions needed for sustainable primary healthcare

THREE KEY FACTS
Dr Samantha Murton is the president of the Royal New Zealand College of General Practitioners; Dr Luke Bradford is the college’s medical director.
OPINION
The ongoing coverage of the GP and primary care workforce shortages and the impact on patients and communities has been sobering, frustrating and disheartening.
It can make for uncomfortable reading.
It’s even more uncomfortable for those of us who are working in it. Across Aotearoa there are over 6000 specialist general practitioners and rural hospital doctors who are turning up every day to do crucial mahi in their communities.
General practice is an incredibly rewarding career. We are privileged to provide whole-of-life care in our communities. We see the very best and the very worst of humanity. We laugh and cry with our patients. We get to use every part of our medical training, and we get to see the true difference we make to our patients’ health and lives.
We are deeply committed to our patients and being able to provide comprehensive, continuous, cost-effective care, close to home is the cornerstone of the health system.
We have over 23 million contacts with patients every year. That’s 400,000 a week or 80,000 a day. No other part of the health workforce provides these volumes of care.
Years of chronic under-investment in primary care is putting our workforce at serious risk, and the consequence of this is risk to patients and the wider health system. We cannot continue to rely on promises, we need to see Government action.
We know there are solutions that would provide some relief and support. The Royal New Zealand College of General Practitioners has been very proactive in bringing these to the table.
For an alternative viewpoint: NZ facing a healthcare crisis; nurse practitioners can help meet the demand
We all know the funding model needs to change but we also need to build up the primary care workforce to meet the challenges of today and in the future.
Let’s start at the beginning and increase the exposure to general practice during medical school, include rural rotations in undergraduate and postgraduate training years, and support students to spend as much time in general practice as possible.
Establishing a postgraduate medical school programme, like the proposed medical school in Waikato, will increase numbers and support them to go rural, providing a well-needed health service boost for the 900,000 New Zealanders who live rurally.
Let’s continue the initiative piloted by Te Whatu Ora-Health NZ using the skills of overseas-trained doctors who move to Aotearoa. Here, they are employed through their first two years of New Zealand medical practice and spend 18 months rotating through general practice placements, followed by six months in hospitals.
This turns the current system on its head. Why can’t our homegrown medical graduates spend more of their time in general practice rather than almost all their first two years in hospitals.
Let’s value our GPs who want to teach and train the next generation of GPs and recognise the benefits of training and upskilling all the healthcare professions that make up a general practice team.
Currently support to be a trainer is limited. As our teachers retire, no one is encouraged to replace them as they must do most of the training themselves at their own cost. Investing in practices, general practitioners and the teams they work in to become trainers of the future generations working in primary care is essential.
Investing in primary care is the most cost-effective way to address the challenges that the heath sector is facing. Investing in primary care will prevent further increases in non-urgent hospitalisations and presentations to emergency departments. For every $1 spent in primary care, $14 is saved further down the line in hospital care.
Successive governments have been unable or unwilling to change this cycle. The current financial crisis faced by Te Whatu Ora-Health NZ and the resulting long wait times and lack of primary care access can be directly linked to not empowering general practice to proactively support patients in the ways that they know will work.
It will only have positive impacts on the communities we support, the health we support and the people we care for.
To all the medical students out there, we encourage you to join us, experience the difference you can make to your patients and help us to create a well-resourced, sustainable and gold-standard primary health workforce.