Two medical unions are calling for Health New Zealand to immediately begin employing specialist general practitioners to increase access in underserved areas.
They want public health GPs to work alongside resident doctors training to become GPs.
In a new report, the Resident Doctors Association and the Apex Union also ask Health New Zealand to create a new primary care arm.
The research looks at issues such as growing corporate ownership and the shortage of GPs along with other primary care professionals.
Resident Doctors’ Association national secretary Deborah Powell told Nine to Noon there was a problem with retaining GPs plus a “retirement bulge” of GPs was looming.
Call to directly employ GPs for under-served areas
The number of GP trainees had been increased this year which was pleasing, but she stressed there was all manner of models with a rise in corporate ownership of general practices.
Corporates were also involved in the urgent care field so “it’s a bit of a mismatch out there”.
The union carried out the research to help with providing more employment options for doctors as well as concern over the knock-on effects for emergency departments when patients couldn’t access timely primary care.
As well, it was worried that people in high deprivation areas such as Gisborne, Tai Rāwhiti, Northland and Counties Manukau were missing out on services.
About 320,000 people were not enrolled in primary care and many of them were in the deprived areas, Powell said.
“We’re saying let’s try a different model ….we need to try something different.”
She said the paper made a good case for trying its suggested model of a new primary care arm in the deprived areas first.
Under the model, Health NZ would set up the practice and employ the GPs.
Among the staff would be house officers who were already on a pathway towards becoming GPs, registrars and fully qualified GPs.
Physiotherapists, pharmacists, nurses, social workers and psychologists would all have a critical role to play also, Powell said.
The organisation representing GPs, the General Practice Owners Association this week has stressed the importance of GPs, the need for continuity of care and not so much emphasis on TeleHealth.
Powell said GenPro had made a solid case. She was concerned continuity of care was already breaking down, especially in the corporate sector.
Changes the union was advocating would see as one example TeleHealth be integrated into the general practice.
“So when you requested a TeleHealth appointment we would do the best to make sure you saw your regular doctor.
“So we’re not looking to move away from best practice in primary care. We’re looking to use the technologies we now have to strengthen it.”
The community practices the union was advocating would be open beyond regular hours, especially in areas like Manukau.
Community practices would operate for much longer hours than traditional medical centres, Deborah Powell says.
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Corporate ownership trend disturbs union
Powell said general practices have traditionally been owned by GPs and the union was worried about the growing trend for corporates to buy them.
One in four GPs is now employed by a corporate which raised questions of where was the priority for spending.
Corporates had responsibilities to shareholders “so it does shift where money is going to be directed”.
Billions of dollars were spent on primary care. GP-run practices prioritised patient care while a corporate must include a focus on delivering a return on investment for shareholders, Powell said.
“So the question inevitably must be asked, is this the best use of public money and where will the priorities sit when it comes to making a decision on spending money to do more for our patients or to satisfy our shareholders.”
She added: “Corporatisation is increasing in primary care and I think all New Zealanders should be watching that and asking some questions.”
Funding given to primary health organisations (PHOs) for their administration would be better directed going from Health New Zealand directly to community general practices, Powell said.
She said the vaccination programme was one example of where two different organisations (Health NZ and the PHOs) were doubling up.
The PHOs were like “a middle man” and cutting them from the equation would free up more money to go into primary care.