The SOS cries of under-pressure GPs are hitting close to home for the country's only MP and practising family doctor Shane Reti.
RNZ went with the National MP to a clinic in Whangārei where he used to work - and heard how his former colleagues feel "devastated" about their future.
In the several decades since Dr Shane Reti and Dr Geoff Cunningham worked together, Northland GPs say they have slowly been buckling under the weight of demand for their services.
The duo greet outside Bush Road Medical Centre, which Dr Cunningham has worked at for the past 20 years since leaving Reti's own clinic.
The red buildings are also familiar to Dr Reti: It is where he used to locum.
Now, Cunningham has told Reti his office has become a place to watch first hand as the country's whole health system falls over.
He said he had been working "endless 65, 70 hour weeks": "The nurses are running, the doctors are running. It's crazy".
Cunningham was seeing more than 40 patients each day, plus phone consults and paperwork - and if he was lucky he would catch a 10-minute break for lunch.
"I'm here, usually consulting from 8am until 5 o'clock, doing urgent paperwork until 6 o'clock. Then I'm back home, quick dinner, and back on the computer for two hours, usually three."
Reti said it was the same right around Whangārei - GP clinics were bulging at the seams and most were not taking new patients.
"Good luck trying to get a same day appointment with your GP."
It was much more than just a busy winter, he said.
"There simply aren't enough doctors."
One recent survey by the Royal College of GPs found half of those currently practising in the region intended to retire within six years.
Cunningham said he had tried hiring new graduates, but with little luck.
"Just recently we were all excited. We had a new doctor start, a fully qualified GP. Young, energetic, brilliant. But after three months work he's resigned. He's starting work at the hospital as a psychiatry registrar.
"The scary thing is he's got three other friends who did general practice together. He's the last of the four to quit. His other three friends have quit general practice as well. The workload was far too high.
"They looked around and saw the income and quality of life was so much greater in hospital jobs."
Cunningham said a "broken funding model" was the main source of his headaches.
Northland was locked into a scheme that meant it could not ask patients to pay more, but clinic funding increases had not met inflation for the past 18 out of 19 years, he said.
Cunningham had not had a pay rise for 10 years, although his workload had increased as the region's population aged.
"It's unbelievable," he said.
"GPs are 81 percent below what they should be paid when you calculate health inflation."
GP shortages were being felt nationwide, but Cunningham said any new GPs heading to Northland would have to work particularly hard for less money than they could earn elsewhere.
Reti said with huge wait times at the local ED as well, the crisis was probably already impacting on people's health.
"You either try and manage the condition yourself... or you turn up at ED. And the tragic experience recently at Middlemore with the woman who did turn up at ED, and wasn't able to be seen is a sentinel message of what happens when primary cares is under able to cope, when after hours is unable to cope and emergency departments become your medical home. Emergency departments should never be a medical home."
On the streets of Whangārei, people told RNZ they were having to shop around to see a doctor.
"I do have a regular but he's very hard to get in to. So you pretty much go to any GP that you can get in to," one person said.
"Sometimes it's really hard switching doctors because you don't have the same rapport and they don't have your file. It is a bit of a concern that they're going to retire and we're having a shortage," another said.
This month, Health New Zealand and the Māori Health Authority have swallowed up the country's district health boards, as part of the sector's biggest shake-up in decades.
Asked if that offered any hope, Cunningham said: "No - and I don't think I can give that answer any quicker".
"We've got a car that's out of gas and the wheels have fallen off. We've just purchased one, maybe two, very, very expensive, big new steering wheels for it. I can't see how it's going to be any better with that."
Reti: Three essential steps to help fix the health system
Reti said his colleagues were rightly "distressed" about the reforms and their future.
He proposed a three-fold solution.
It needed to include the 45 percent of GP graduates that had, historically, come from offshore, he said.
"They've recently been given green list, day-one residency, which is a good thing. But we're not a welcoming environment.
"Who would want to come and work in an environment where they're overworked, overstretched, underpaid and exhausted? That's not a welcoming environment. We need to figure out those immigration settings.
"Secondly, we have doctors and nurses driving UberEats. They're already here. They're permanent residents. Why can't we find that pathway for them to onboard?
"Then in the medium to longer term we need to grow our own home grown, culturally sensitive and culturally competent doctors and nurses, and turn on those intakes at medical schools... you've got to start somewhere, and that somewhere is here and now, today."
Reti said giving primary care the equipment, tools and people to do their job well, meant everyone would feel the benefits.
RNZ
