Primary care practices warn of collapse due to staff shortages, funding shortfalls

Twelve leading primary care organisations have issued a grim warning - they're at risk of collapse due to staff shortages and a lack of funding. 

Whānau Āwhina/Plunket, Family Planning and Hospice have all been forced to cut back or close some services. 

And GPs say they feel "ignored" by the Government, despite mounting evidence of clinics drowning in debt.

Gisborne GP Fergus Aitcheson said the state of general practice is the worst he's seen in his 16-year career.

"So I would urge whoever has got the reins come October 15 to have a really serious look at this, because the message from general practice is clear - the building is on fire," he told Newshub.

That fire, he said, is in part due to an outdated, broken, Government-controlled funding model.

"If productively falls slightly in general practice there's a massive knock on effect to the emergency department and the secondary sector."

It causes 'ramping' at emergency departments, as primary care that prevents hospitalisations diminishes.

"The general practice plane is running out of fuel," Dr Aitcheson said.

Labour's Dr Ayesha Verrall accepts GP funding is "not fit for purpose" and "many changes are required".

But Whangārei GP Dr Geoff Cunningham told Newshub he's "got no confidence at all."

"We've heard all this before and nothing has happened."

Whangārei GP Dr Geoff Cunningham.
Whangārei GP Dr Geoff Cunningham. Photo credit: Newshub.

That's because the Government commissioned its own review last year which stated funding "does not align with patient need" which is a "serious deficiency". 

"We've just been given lip service and undermining from the government and gaslighting. I think for general practice, we've had enough," Dr Cunningham added.

Newshub asked Dr Cunningham if he felt GPs are being ignored.

"Absolutely," he replied.

His practice in Whangarei has 11,000 patients, but like more than a third of general practices across New Zealand, it made a loss in the last financial quarter.

Dr Cunningham said that has serious implications.

Newshub asked if closure is possible.

"It's a real possibility," he said.

"I think it's terminal unless something immediately is done for general practice funding."

There's another pressure - retaining nursing staff. Many are leaving primary care for higher-paid hospital roles. 

"We had a going-away for one of our nurses last week. She's been offered $10 an hour more at Te Whatu Ora than we can afford to pay her," said Dr Cunningham.

That nurse pay gap has seen 12 primary and community care organisations come together to demand change.

Whānau Āwhina/Plunket has 35 nurse vacancies. 

"At the vacancy rate that we've got at the moment, that potentially means that we are missing probably close to 140 visits to whānau every single day," said Fiona Kingsford, chief executive at Whānau Āwhina Plunket.

Family Planning has also lost nurses to hospitals, which has forced service closures.

"We've ended up having to close clinics," said Jackie Edmond, chief executive at Family Planning.

"We had 64 days where our clinics were closed in August and we also have really, really long waiting times because we have no appointments available for people," she told Newshub.

It's the first time they've come together to call for urgent action. 

"We've done it because we're all facing the same issue of unable to employ or retain nurses which means our services are being affected," said Wayne Naylor, chief executive at Te Kahu Pairuri o Aotearoa / Hospice New Zealand.

"We can't run services. We are reducing services," he told Newshub.

The lure of a hospital role plays on the mind of practice nurse Michaela Barton.

"We've come into primary care or come into nursing because we want to help people, and care for people. But if we're not being cared for and looked after ourselves, how can we keep providing that? We will need to go elsewhere to be able to care for ourselves," she said.

Despite clear problems, there's no firm guarantee from Labour or National they will address pay parity for nurses, or change GP funding. 

"It's extremely disappointing and it's dangerous," Dr Aitcheson said.

Dangerous for the patients, whom he believes could eventually be left without a family doctor.

Gisborne GP Dr Fergus Aitcheson.
Gisborne GP Dr Fergus Aitcheson. Photo credit: Newshub.

Newshub asked Labour and National if they would commit to closing pay disparities for nurses.

Labour's Dr Verrall said fair pay is important. 

"Fair pay is a key step to attract more nurses, and this will be a priority for us if re-elected." 

But Dr Verrall did not address a question from Newshub about if Labour would change the model for GPs so they're properly funded.

"General practitioners and primary health care workers are essential for improving the health of New Zealanders," she said.

National would also not commit to changing the funding model, but Dr Shane Reti hinted at possible changes. 

He said National had announced a $52 million immunisation incentive program for GPs.

"We will have more to say on remuneration in the health manifesto. National will explore implementation of the Sapere Report recommendations to improve the capitation funding model."

Dr Reti said Labour made a mistake by not giving practice nurses the same pay as their hospital counterparts.

He said National "supports in-principle" pay parity for DHB, aged care and general practice nurses.

The General Practice Owners Association of New Zealand told Newshub there have been 31 Section-14 notifications made by GP clinics across Aotearoa since June this year. 

A Section-14 notice is a formal "notification of problems".  

Clinics must notify their PHO (primary health organisation) if there are risks they can't meet obligations under their Contracted Provider Agreement.