GPs feel financial strain

SOUTHERN general practices, like doctor surgeries countrywide, are enduring financial hardship due to the Covid19 pandemic, WellSouth chairman Doug Hill says.

‘‘We think it is varied. All of us are hurting but to different degrees,’’ Dr Hill said.

‘‘In the first few weeks (of Alert Level 4) there was very little money going across the counter of general practices, although as time goes by I think things are starting to pick up a little bit.

‘‘I am reluctant to overplay the financials because while, yes, we are hurting, there are people who are hurting a lot more than us.’’

Earlier this week Health Minister David Clark said discussions continued between the Ministry of Health and the primary care sector about how to cover additional costs for GPs resulting from the Covid19 pandemic.

WellSouth regularly consulted leading GPs from across the southern region, and while doctors were struggling to cope, their morale was high, Dr Hill said.

‘‘As a rule, GPs are extremely proud of what they have achieved.

‘‘We have made changes in general practice which would have taken us years but in some cases we have had to implement them within hours.

‘‘They have built new capacities into their practices.

‘‘They are using new digital technology, and GPs are already planning for the next phase and how they can continue to enhance care for patients.’’

However, those patients needed to overcome any reluctance to see their doctors, Dr Hill said.

‘‘We know that there are patients who have been sitting at home waiting to have something seen who have delayed their treatment and hence their diagnosis.

‘‘A delayed diagnosis is never a good diagnosis. The sooner we can see people the better.’’

Fewer patients had seen their GPs in the past month so the number of referrals to hospitals would have been fewer.

All patients who have needed hospitallevel care have been seen, but it would be a big task to catch up on postponed procedures, Dr Hill said.

‘‘The hospital will have lost four to six weeks of work and that is work that needs to be done.

‘‘We are going to have to work together, both primary and secondary care, to work through that.’’

As well as treating their own patients, GPs have played a crucial role in Covid19 testing, Dr Hill said. GPs have carried out about half of all Covid19 testing in the South.

❛ We know that there are patients who have been sitting at home waiting to have

something seen

WELLINGTON: GPs calling for reform of New Zealand’s health system after hard lessons learned from Covid19 want the delayed Health and Disability System Review to be released.

Doctors say examples of failures in a health system with 20 district health boards for a population of five million means the time is right for serious reform.

The New Zealand Medical Association and General Practice New Zealand are both calling for the Government to release the Health and Disability System Review recommendations that were due out in March.

The review, chaired by Heather Simpson and backed by a panel of health experts, aimed to ensure the health and disability system was better balanced towards wellness, access, equity, and sustainability.

Its interim report found the health system’s structure was overly complicated and lacked leadership, and said people using the services need be placed at the heart of the system.

However, it did not provide recommendations, something the final report which was due in March this year was intending to do.

As to why the review has not been released, Prime Minister Jacinda Ardern previously said: ‘‘We decided, of course, that we wanted to allow ourselves the time and the space to deal with the pandemic we have in front of us before considering some larger, widerscale health system reforms.

‘‘I think that’s the right decision.

‘‘I don’t think it would be right to plough into that when we’re right in the middle of managing a global pandemic.’’

The final report has been completed and will be presented to the Government when it requests it.

Medical association chairwoman Kate Baddock told RNZ yesterday the Covid19 virus had forced the health system to adapt, and the lessons from it should not be lost.

‘‘I don’t think any country was ready for this pandemic, but I do think it has highlighted a need for us to look at how much of our health system should be centralised and how much of it should be decentralised and managed centrally or locally.’’

‘‘For instance, general practice and within hospital settings where a lot of what was delivered facetoface is now being delivered virtually.

‘‘Innovation is occurring and what you want to be able to do is take some of that and embed it into our future.’’

She said the reasons for the delay of the health and disability review were understandable during the crisis, but now was the right time to be looking at how to improve New Zealand’s health system.

‘‘We haven’t asked for this to be released earlier even though it’s now at least a month since it was due to be released because we appreciated that we were still in crisis,’’ she said.

‘‘Things are now under control and this situation we currently have may last the next six to 12 months.

‘‘This is a good time to see what the report actually says . . . to have the report delivered and received by Government so they can look at what has been suggested.

‘‘This is a good time to start to digest the contents of that report and look at what we should be doing so we can shape the future the way we want it to be.’’

She said the NZMA supported having fewer — or at least more centralised — DHBs.

‘‘It might not be that they become fewer in number but rather, as I say, that they regionalise the way they do things.’’

There were also changes needed to the structure of general practice.

‘‘Absolutely — you’ll have heard about the cash crisis that occurred in general practice when we first went into Level 4 lockdown and that is because of the dependency upon the capitation that comes through from the Government.

‘‘That has been chronically underfunded for a decade.

‘‘I would absolutely hope that the report addresses the way that general practice and primary care is funded and how that needs to change also.’’ — RNZ