GP shortage hurts regions Finance minister likes a laugh
A crisis looms in the countryside as a generation of doctors retires, writes Rachel Thomas.
Doctors Paula Hyde and Lewis Arundell are Fairlie’s only GPs, and it’s been that way for the past 21 years.
The husband and wife team would like to be retired within 10 years, but they fear no one will take over their demanding practice, which serves around 2600 patients and requires a complex combination of skills.
Nationally, 44 per cent of GPs have said they want to retire within 10 years.
In South Canterbury, home to Fairlie, that jumps to 88 per cent, according to figures from the Royal New Zealand College of GPs, which warns of a looming crisis.
In the neighbouring West Coast, the community has just 60 full-time equivalent GPs per 100,000 people – about 15 fewer than the national average.
Taranaki and MidCentral are even worse off – Taranaki has just 55.9 per 100,000, and MidCentral 57.8.
More than half of Northland’s GPs are eyeing retirement.
Wellington GP Dr Jeff Lowe said employment opportunities for partners and education options for children are the two key challenges rural communities face when attracting doctors. A rural location might mean boarding school for the children.
‘‘I think we’re more transient and different generations have different wants and needs in terms of lifestyle,’’ Lowe, also chairman of General Practice New Zealand, said.
‘‘You have got to look at whether general practice is an attractive career choice for graduates coming through. What we need is a workforce and a funding formula.’’
Health Minister Jonathan Coleman passed on requests for comment to the Ministry of Health.
Coleman has previously said his expectations in future are for fewer If GPs are looking at a shortage, the same will apply to nurses. GPs and more nurses, working together to deliver primary healthcare.
Nurses are writing more prescriptions, filling out death certificates, giving out insulin, and increasingly performing triage services as part of attempts to relieve pressure on general practitioners.
Ministry of Health primary care manager Anne O’Connell said rural and hard-to-staff locations were being addressed through medical immersion programmes and a voluntary bonding scheme, which provides graduate funding.
To date, more than 1350 health professionals have been funded through the scheme.
O’Connell said locums could be called on to relieve rural or burntout doctors.
Back in Fairlie, Hyde said the only reason she and her husband had endured so long was thanks to regular holidays, made possible by a visiting locum.
Yet Labour health spokeswoman Annette King said locums were sometimes brought in from Australia and ‘‘cost a lot of money’’.
‘‘There are between 500-600 Kiwi doctors in Australia and I think there’s an opportunity to bring home a recruitment drive.’’
King said nursing shortages would also be a factor, as their age profile is similar to GPs’.
Her concerns are shared by Fiona Thomson, chief executive of General Practice New Zealand.
‘‘If GPs are looking at a shortage, the same will apply to nurses.’’
That said, Thomson believed New Zealand’s nursing workforce ‘‘is the most developed in the world’’.
Hyde said general practice offered a decent living, even rurally, but it was hard work. ‘‘The more experience students have in general practice the better and I know they’re trying to do that, but the only problem is it takes a lot of time.’’
He’s famous for many things – a dildo to the face mostly. I hate to bring that up again, but there it is. As impossible to avoid as, well, that particular instrument appeared to be. Steven Joyce’s reaction to that incident offers an insight into the type of foil he’ll be to the drywitted Prime Minister Bill English.
Much has been made of the loss of John Key’s ‘‘jokester’’ personality, but Joyce can laugh at himself, and on an international scale.
More importantly, there are a great many more serious moments in his history, that offer some hints as to the type of finance minister he could turn out to be.
Once described as Key’s six million dollar man, Joyce is now Prime Minister Bill English’s $8.5 billion man, in charge of spending his precious surpluses.
Little about the Government’s spending plans is likely to change, however.
Suspicions that English will still pull the strings in finance overlook the fact that Joyce was probably almost as integral in setting the Government’s spending strategy in an election year anyway. Tax cuts will feature, but be downplayed to deny Labour any oxygen.
Joyce’s point of difference might be a more relaxed attitude than his predecessor to corporate subsidies – having had a hand in pushing nearly all major examples of such through, with considerably less power than he has now.
The nearly $200 million deal to secure Warner Bros to film the Hobbit trilogy in New Zealand, a $30m bailout to the Tiwai aluminium smelter, the SkyCity deal and a $43m loan guarantee to MediaWorks for radio licences all come to mind.
Nearing the end of the campaign trail in 2014, I was at Canterbury University following John Key and Joyce. As Key delivered a speech, I received a email alert, turned to Joyce and said ‘‘minister, um... are you being sued by Eminem?’’
A frustrated smile, followed by an eye-roll and ‘‘yeah, gimme 10 minutes to turn this sod, and we’ll do a standup,’’ he said.
That standup was his first foray into international comedy, famously telling us – and later a sizeable US audience when my iPhone footage of Joyce was picked up by John Oliver – that ‘‘we think it’s pretty legal’’, referring to National’s choice of backing music to a campaign ad.
What kind of finance minister could Joyce be? Perhaps not one to steer the ship too far from the course he’s been part of setting, though less afraid of a contentious business deal.
And should controversy come knocking? It’s not hard to imagine the ‘‘I’m pretty relaxed about it’’ approach familiar thanks to a recently retired prime minister.