MIQ costs exacerbate rural GP staffing problem
The bill for managed isolation of overseas staff could be the final straw for many burnt-out rural GPs who say the costs have created a staffing crisis, the New Zealand Rural GP Network says.
A chronic shortage of doctors has been exacerbated by the cost of managed isolation and quarantine (MIQ) for overseas recruits, the New Zealand Rural GP Network chief executive Grant Davidson said.
Some GPs were ready to quit their medical centres, as maintaining a quality practice had become untenable, Davidson said.
‘‘Many of these doctors in these small practices are overworked, they are stressed, they are working long hours ... and they are just at their wits’ end and this is one more barrier.’’
Patients have also suffered because of the knock-on effect of fewer appointments.
In the last year permanent and short-term vacancies increased from 88 to 103 across rural GP practices, Davidson said.
Meeting New Zealand medical council registration requirements, finding flights, getting a room and paying for MIQ were putting many potential recruits off.
GP Nick Loveridge-Easther, coowner of¯Opunake Medical Centre in South Taranaki, said his practice had been unable to replace a Belgian locum doctor who finished his 12-month contract in November, despite starting the recruitment search six months earlier.
The centre was forced to reduce appointments for its 3500 enrolled patients, despite the area being an hour’s drive from the nearest hospital and having a high-needs population.
‘‘South Taranaki is really hard to staff and that’s because of the
social and professional isolation that occurs in the clinics, so you’ve got to get quite a specific doctor to be able to function in that environment.’’
In September, the New Zealand Rural General Practice Network, supported by seven primary health organisations, wrote to the Government pleading for an exemption for health workers from the cost of MIQ.
Davidson said it was disappointing Immigration Minister Kris Faafoi had not made himself available to meet the group.
A Government spokesperson said critical health workers were excluded from an increase in MIQ fees which took effect on January 1.
‘‘The current $3100 fee is significantly less than the average costs across the MIQ network and the balance is met by a government subsidy.’’
Loveridge-Easther said he would be willing to cover the costs because his practice would not survive if he could not fill the role.
‘‘We need that GP on board. If it requires us to pay for it, we don’t have any choice in that matter – it’s either that or you don’t offer the service.’’
Loveridge-Easther’s semiretired GP father from Nelson, Graham Loveridge, offered to help fill the gap by working full-time at his son’s centre for a few weeks.
Some overseas applicants had pulled out of the recruitment process after realising how much they would have to pay for MIQ to bring their family with them, Davidson said.
The National Hauora Coalition (NHC) chief executive Simon Royal said medical centre staff shortages were symptomatic of ‘‘the underinvestment to date in developing our own population as medical practitioners’’.
‘‘We do not have a medical workforce that is representative of our population, and we do not see how having more non-indigenous GPs from overseas will help that.’’
The NHC, which supports 57 kaupapa Ma¯ori clinics across five district health board (DHB) areas, was addressing staffing shortages with nurse-led clinics.
Davidson said the Rural GP Network fully supported better investment in building the New Zealand workforce and had programmes in place to increase Ma¯ori representation, but overseas staff were needed to supplement services until those aims were achieved.
Loveridge-Easther agreed with the NHC and said there was a need to increase participation of rural Ma¯ori in medical training, increase recruitment of specialist nurses and utilise tele-medicine more.
‘‘We don’t need a GP who is an absolute genius. We need a GP who relates to the population, that is practical, who enjoys living and working in a rural environment so it’s a sustainable relationship.’’
Royal New Zealand College of GPs medical director Bryan Betty said the shortage would result in poorer health outcomes and put more pressure on already stretched emergency departments.