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Budget 2023: GPs are the heart of healthcare, but little specific support shown

This year’s Budget, “Support for today, building for tomorrow”, is focused on flood and cyclone recovery, and rightly so. However, despite the finance Minister’s comment about “expanding GP services” it is hard to see where that attention has been applied.

The Royal New Zealand College of General Practitioners welcomes the announcement of $20 million to lift immunisation and screening coverage for Māori and Pasifika, as well as the removal of the $5 prescription fees for all New Zealanders. “All of our members will have patients who struggle to pay for their prescriptions and removing this barrier is good news,” says College President Dr Samantha Murton.

Social determinants of health are another area where attention has been applied and this is essential to lifting the burden on the delivery of health services, especially in the community.

However, the College is disappointed to not see more immediate support for the sustainable delivery of medical care in the community through GPs, rural hospital doctors and their teams.

Currently, 95 percent of Kiwis are enrolled with a general practice, and 90 percent of medical problems dealt with in general practice.

Dr Murton says, “The earmarked $118 million to help reduce waiting lists by ‘improving patient flow and enabling planned care to be delivered in primary care’ sounds good in theory, but serious attention needs to focus on growing the number of GPs and rural hospital doctors being trained as specialists, supporting their wellbeing, and supporting those thinking of retirement to stay in the profession.

“There have been some steps to support training with Minister Little’s announcements last year but there is much more that can be done. We need to have a solid plan in place and significant investment to grow our own workforce.

“To highlight the urgent need for more GP investment, if the 425 specialist GPs aged over 65 retired tomorrow, we estimate that 725,000 more New Zealanders would be without a doctor. When it takes between 11-14 years to train as a specialist GP, it will be our patients and communities who suffer.”

College Medical Director Dr Luke Bradford says, “Specialist general practitioners, rural hospital doctors and their teams are the heart of healthcare – which is fittingly the theme of tomorrow’s World Family Doctor Day campaign.

“The announcement of more equitable primary care funding for general practices based on enrolled high-needs, Māori and Pasifika populations is welcomed but care needs to be taken to ensure it goes to patients who need it the most. An in-depth review of the current capitation model would enable practices to recruit and retain this specialist service.”

Results from the College’s 2022 Workforce Survey, completed by 70 percent of the membership (3,488 respondents) painted a grim picture that is getting worse. How long will we watch this steady decline in our specialist medical workforce who save the country significant costs?

“With election campaigning about to begin there is sure to be much talk about how to turn around our health sector. To make a significant difference there needs to be immediate action as well as long-term planning specific to the general practice workforce. We need to see our decision makers walking the talk before it is too late,” says Dr Murton.

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