General practices issue formal warning to Government, doctors at breaking point

If you've found it hard to get a doctor's appointment recently, there's a simple reason - general practitioners (GPs) are in crisis mode.

In the past month, an unprecedented 155 GP clinics have issued a formal warning to the Government, saying they’re in danger of not being able to provide services.

It’s been triggered by a pay claim lodged by the nurses’ union last month, and what GPs say is years of inadequate funding of primary care.

Primary care is under the pump across the country. Almost 20 percent of all clinics nationwide have raised concerns. 

In Christchurch, GP Api Talematoga says he and his colleagues are at breaking point.

“I’ve been in practice for 30 years and I’ve never been exposed to this level of stress,” he told Newshub.

Wellington GP Rachael Waters feels similarly exhausted. 

“It’s the worst I’ve ever seen. It’s the most stretched I’ve ever seen. It’s the most difficult, it’s the busiest."

Many practices are in financial strife, and almost all lack staff and are overloaded with patients. 

“Any patient will know that they can wait two, three, four weeks to get a GP visit. It’s not okay and the health of New Zealanders is suffering, and we need to fix it,” Dr Waters told Newshub.

Adding to the pressure, the NZ Nurses Organisation lodged a pay equity claim with the intention of boosting pay for nurses in primary care. 

“We’ve got this significant gap between what nurses in hospitals are paid and what nurses outside hospitals, in what we call the funded sector, are paid," said NZNO chief executive Paul Goulter.

GPs want their nurses paid more but say they can’t fund it.  

“I think it's a disaster waiting to happen," said Dr Waters. 

In response to the union’s claim, since mid-December, 155 GP clinics have issued what’s known as a Section 14 notice. 

This is a "notification of problems", or “significant risks” where the clinic has concerns it can't perform the services it's contracted to do. 

The clinic's local Primary Health Organisation (PHO) is contacted, which is then obliged to inform Manatū Hauora/the Ministry of Health.

Paul Goulter says the NZNO claim to close the gender pay gap for nurses working outside of hospitals should not be funded by overburdened general practices. 

“It needs to be funded by the Government," he said.

Health Minister Dr Shane Reti won’t commit to that.

“I can’t preempt budget decisions. We’re still working through all of that discussion here now.”

But Dr Reti does want to give more money to GP clinics.  

“I want to better remunerate general practice."

Asked if that would involve a complete overhaul of the funding model, he told Newshub: "I’m interested in exploring that."

GPs say that’s critical, as they play a vital role in detecting medical issues early.  

General practice is seen as the foundation of the country’s health system because those who see their GP are less likely to end up in already-overloaded hospitals.  

The chair of general practice owners advocacy group GenPro, Dr Angus Chambers, said various Government-commissioned reports have identified the current funding model for GPs is broken. 

However, that's largely been ignored, he said.

“It should be the foundation of our health system, but for a long time it’s been a poor cousin."

And Dr Chambers said expecting GPs to fund nurse pay rises will have devastating consequences and will result in some practices closing.

"We do fear that communities will lose their general practitioners if it [funding of primary care nurses] is not done in the right way."