Some GP practices enrolling lots of low-need patients to get more funding

A new report into the GP workforce has found some practices are deliberately enrolling patients with low health needs in order to have more people on their books and make more money.

Its authors, Professor Des Gorman and Dr Murray Horn, blame the health system's funding model, calling it 'accountability free' because it pays primary healthcare practices and GPs not on the number of consultations with patients but on the number of people on their books.

"They encourage avoiding high-risk patients and they encourage not being available after hours," said Gorman

He said that's fuelling a decline in the number of GP work hours and a decrease in the GP-to-population ratio

"We have a significant workforce crisis in New Zealand in regards to health services," he said.

It's something that Porirua GP Sean Hanna agrees with. He's seeing wait times of two to four weeks for regular appointments.

"We're under the pump, there aren't enough of us", Hanna said

However, he disagrees with Gorman about clinics only taking on low-needs patients.

"We're actually run off our feet. Practices like us are embedded in a high-needs community. We have high utilisation rates. We don't cherry-pick patients, that's just nonsense," said Hanna

What they do agree on is that the funding system is flawed.

Hanna said clinics like his need more funding to increase diversity amongst GPs

"We need to redesign how we are looking at primary care, and that needs to include funding properly what we do," he said.

"It's not working, it's actually quite dysfunctional at present," said Gorman.

Concerns that Health Minister Dr Ayesha Verrall is aware of. 

"I agree that the funding system for GPs is not fit for purpose. But funding alone is a blunt tool. Many changes are required to enable GPs to provide the care they should be able to in communities," said Dr Verrall.

To fix the problems, the report recommends a crisis response to maintain and enhance GP services, boosting the number of medical students, encouraging GPs to retire later and work longer hours, and overhauling the funding system.

Health New Zealand's interim director of primary, community and rural, Emma Prestidge, told Newshub they're working on the funding model. 

"We definitely are committed to ensuring we have a fit-for-purpose funding system that means people in New Zealand can see health professionals when they need it," she said.

Adding that Te Whatu Ora Health New Zealand has increased GPs' pay to retain more doctors.

"We are putting investment in to ensure we are moving in the right direction," said Prestidge.

While Dr Verrall said the recent announcement of a Workforce Plan is focussed on new training models, there are also new ways of working and new models of care to embrace the multidisciplinary workforce.

"We are increasing the number of GPs trained annually to 300 by 2026 and we are working with the Royal New Zealand College of General Practitioners to strengthen the GP training pathway," she said.