Accessing healthcare a fundamental right

OPINION: General practice doctors are an integral part of our health system. But some GPs say it’s on the brink of collapse. What can be done to solve this? An MP from each side of the House gives their views.

My mum is a GP. She set up her medical clinic in the 80s and has looked after five generations of the same South Auckland families.

When I was little, there were always shoes at the door at the weekend because someone had come to see her or my dad, the local councillor, to fix a problem. It made me want to solve problems for people, and I’ll always admire the doctors who are at the heart of their community like my mother is.

GPs should have good salaries and conditions, and they should work within a health system that helps doctors fix problems for their patients, not one that makes things harder for people who are already more likely to be unwell.

That’s why Labour funded health and tackled health inequality head on, and why it is crucial that the current Government be held to account in its stewardship of the health system.

The past few years have been a challenging time for the health system across the board, with Covid-19, an ageing population and people presenting with increasingly complex health conditions.

Workforce shortages have been a particular issue, so we put nurses and doctors on the Green List, meaning it is much faster for them to come to New Zealand to work. We also increased university places in Auckland and Otago by 50 from this year, so we can train more doctors here.

Labour delivered historic pay increases for nurses, to help attract people to the profession but also because we value them and the work they do. And the annual health budget overall was increased by about $10 billion by 2023/24 – a massive investment in our people.

Health was merely an afterthought in the National Government’s first 100 days. We’ve seen none of the kind of thinking from them that would actually make a difference to doctors and nurses on the frontline.

However, they’ve got form. Under the previous National Government, health was chronically underfunded. District health boards were routinely forced to run deficits or reduce the services that they provided.

There was sustained underinvestment in health infrastructure, and regions with hospitals that were too old or too small to meet the needs of their populations.

The numbers around health funding are so large they can sound meaningless.

Thankfully, as part of the planned move to three-year health budgets, the Ministry of Health and Treasury have estimated what additional funding the system requires in Budget 2024 – an additional $4.2b a year by 2026/27.

Both Labour and National committed to this investment during the election. This Government must follow through on that promise.

STUART SMITH, NATIONAL MP, KAIKŌURA

As they say “tomorrow is another day”, but that offers little comfort for those working in general practice. As Health Minister Dr Shane Reti said last week, a broken general practice system is not what an incoming government expects to inherit.

Warnings from those in the health sector as wait times climbed and emergency departments were overrun largely went unheeded. Instead, the previous Government focused on amalgamating district health boards and creating new bureaucracies in Wellington.

Now, the chickens have come home to roost.

There is no easy fix, no singular action that will remedy the many long-standing issues affecting general practice.

Every week, GPs contribute long hours seeing patients and also undertaking other non-clinical tasks. The disparities in geographic regions and population groups don’t help either, also contributing to inequitable access to primary healthcare.

The price we pay for an under-resourced primary care system that struggles to meet demand is reduced access to securing a doctor’s appointment and hospital emergency departments swamped with patients presenting with more serious conditions.

This is more costly in the long run and leads to poorer outcomes for patients.

A new direction in health is needed, starting with greater ministerial oversight, which we will deliver.

We have already started work on addressing the critical workforce development needs.

The Ministry of Health and the University of Waikato recently signed a Memorandum of Understanding to progress the business case for the establishment of a third medical school.

When a robust cost benefit analysis is completed as part of that memorandum, this school has huge potential to help address the shortage of New Zealand-trained doctors and would be a big step forward.

In addition, we have already increased the number of medical students to be trained at New Zealand’s existing, top quality medical schools at Otago and Auckland universities this year.

We will also ensure there are effective health targets in place to drive continual system improvement.

The five targets we are focused on will deliver faster cancer treatment, improved immunisation rates, shorter stays in hospital emergency departments, shorter wait times for first specialist assessments and shorter times for elective treatment.

Establishing a fit-for-purpose sustainable general practice model is a key part of achieving these targets.

Unlike the last government, we will not wait years to act. Nor will we shy away from tackling the hard issues, because

New Zealanders have a fundamental right to access healthcare.