Doctors say a crisis looms due to funding and GP shortage

GPs say they're under mounting pressure and it's putting the whole health system at serious risk.

Hundreds of doctors have written to the Minister of Health warning of a looming crisis due to funding issues and a GP shortage.

Dr Margaret Goodey loves her job and hopes to inspire the next generation of GPs but she fears the current practice is no longer financially viable.

"I feel very passionate that it needs to be fit for the future and the funding is not, it's letting us down," says Dr Goodey.

She's one of more than 350 doctors who've written to the Minister, highlighting the issues facing General Practice.

And funding is the biggest concern.

One GP writes, "Half of the patients who should be able to access cheaper fees cannot. Whilst half of those accessing the cheaper fees could well afford to pay their own way."

Another says "I have been providing a free after hours service to the homeless ... as this vulnerable community cannot afford to pay a GP."

Dr Goodey charges $60 per visit.  Because her surgery is in the affluent Auckland suburb of Meadowbank she gets less Government subsidy and therefore has to charge more, regardless of the wealth of the patient.

Practices in low income areas get higher subsidies and therefore patients pay less, even if they're rich.

"That whole capitation calculation just, it's just archaic," says Dr Goodey.

GPs are putting the pressure on the Government to launch a review into a fairer funding model.

"With the good data that we have available now there is absolutely no reason we couldn't come up with a formula that would target the people who need it the most," says Royal New Zealand College of General Practitioners (RNZCGP) president Dr Tim Malloy.

Last year half a million New Zealanders avoided going to their GP due to cost. Dr Malloy says that has downstream consequences.

"Increasing hospital admissions, increasing presentations to the emergency department. Latter presentations with complications that should otherwise have been treated earlier," Dr Malloy says.

Health Minister Jonathan Coleman agrees the funding model, which has been in place since 2003, is blunt.

"It provides very cheap visits for all within its boundaries, but half of these people are not high needs or low income," says Dr Coleman.

He says the best solution is a new personalised funding model which attaches to high needs or low income individuals.

"I've had officials working on a more individualised and more targeted approach for some months now. I am interested in finding a workable solution, which is simple yet effective."

But it's not the only funding that RNZCGP say needs addressing, they want further investment in GP training to replace those nearing retirement and fill the vacancies in rural areas.

Health Workforce New Zealand has been working with the RNZCGP and has increased the number of funded GP trainees from 50 in the early 2000s to 185 new GP trainees each year.

But Dr Malloy says that's not enough to meet the shortfall.  "We need to train 300 a year if we are to bridge the gap."

Dr Malloy will deliver a giant postcard with the GPs messages to the Health Minister at Parliament on Wednesday.