Auckland GPs 'overloaded, fatigued' as Emergency Department patients redirected

By Amy Williams for RNZ 

Auckland GPs say they are fatigued and overworked as an overflow of winter patients diverted from emergency departments knock on their doors.

In South Auckland, 27 general practices offered free appointments over the weekend at the request of Counties Manukau District Health Board, and will do it next week too, because Middlemore Hospital's ED has been overwhelmed.

But GPs said they were not the long-term solution to the crisis and more planning should have been done.

It was late Friday afternoon when Dr Salam Silah received a phone call asking if he'd extend his clinic's weekend hours and offer free consultations.

Botany Medical and Urgent Care operates two clinics, employing 10 GPs.

Silah agreed and spent Friday evening preparing, ensuring there would be enough doctors and nurses working to see extra patients.

"We are overloaded with the workload, we are all fatigued so I'm not sure how long this can go on. It's very difficult."

It was not easy - the weekend was busy with about 25 percent more patients than usual walking in the door, 10 of whom would have gone to hospital if the free clinics were not available.

"It means that we are not having any breaks and it's been many months like that since Covid started. We are short-staffed."

Silah said the free clinics were only a short-term fix.

Royal New Zealand College of General Practitioners medical director Dr Bryan Betty agreed.

"General Practice is at capacity, the hospitals are at capacity and this is a response to essentially a crisis situation that has arisen."

He said GPs were already grappling with staffing shortages and a winter surge in flu cases coupled with Covid-19 were putting added pressure on practices.

"This is short term, there are longer-term issues here about how strategically we solve the problem that's emerged which is not enough workforce in certain areas of New Zealand to deliver care."

Betty would like to see the government and Health NZ develop a strategy to address the shortage of GPs and nurses.

National Party health spokesperson Dr Shane Reti said the free weekend clinics are a "haphazard band-aid'.

"What I'm hearing from my colleagues is that this was very hurried that many of them didn't know til late in the piece and yet to respond they've still got to try and organise staff. I'm hearing but I can't quantify it that the uptake in the clinics wasn't what was anticipated."

South and east Auckland lack a 24-hour emergency clinic.

"What is the nature of the primary care after hours offering in and around Middlemore or in fact across the country because in my view it's quite broken and quite fragmented."

Reti said long-term solutions are needed, such as addressing the health workforce shortages and funding emergency care providers.

With a long weekend ahead, there will be extra pressure on GPs offering free clinics.

"I have grave concerns. It's a long weekend so we're going to have people travelling so it's not even as if we're going to have residents, for example around Middlemore, who know where their primary care doctor is."

Betty said GPs would step up but it would be tough.

"There is only so much cap in the system and pressure is being put on GPs to do this type of extra work, they will try and do it as they can but we don't have a limitless resource here."

The Wellington region, through Capital and Coast and Hutt Valley DHBs, is also struggling with staffing shortages and will be offering vouchers for virtual GP consultations and local after-hours clinics.