Down to the No 8 wire
The Ministry of Health has just renewed a contract for the next three years to fund temporary staff – locums – just so rural GPs can have a holiday.
But there’s no long-term fix for the ageing population, Philip says. ‘‘We haven’t got a long term strategy for the country. We have not planned for 25 years in advance.’’
Something’s got to give
We all know New Zealanders are getting older.
By 2036, up to 24 per cent of New Zealanders will be aged 65 and over, compared with 14 per cent in 2012, according to Statistics NZ.
‘‘We’re going to have a phenomenally large number of people over the age of 90,’’ Philip says.
‘‘Who’s going to look after those people? Is it going to be me as a 70-year-old doctor?’’
The palliative care backpack will have to be carried by someone, says Dalton Kelly, chief executive of the New Zealand Rural General Practice Network (NZRGPN).
‘‘Hospices aren’t going to be in remote and rural parts of New Zealand so it’s going to fall on the rural practitioners to deliver that.
‘‘That’s just going to be piling layer upon layer on to the rural general practices. We need someone to go there and deliver those services and it needs to come with money.’’
Dr Tim Malloy, a rural GP of 30 years and president of RNZCGP, has seen 11 health ministers come and go since he’s been in the industry, ‘‘but we’re still here and we’ve still got the problems’’.
‘‘For those who provide the backbone of the country that we should be treated in this way by political masters, I think it speaks for the system.
‘‘Once the students graduate we can’t then afford to, as we currently do, have them train only in hospital and therefore break the cycle for rural communities.
‘‘It’s in those critical years you are deciding your future career pathway.’’
The NZRGPN and the Royal College of GPs (RNZCGP) both like the idea of a national solution.
‘‘We have the right number of medical students, but they’re not in the right places,’’ Kelly says.
‘‘Lots of people will have views on how that could be done – you could give them more money, you could write off their students loans, give them free housing, free cars, free whatever and incentivise them – and that might work for a year or two years.
‘‘But as soon as their first child needs to go to a primary school they will probably look at moving somewhere different – I don’t know. It’s a biggie.’’
The Rural Health Alliance (RHAANZ) says $40b, or 19 per cent of GDP, was generated by the agri-food sector in 2011-12 – much of it generated from the rural population.
‘‘Collectively, the rural population of 600,000 people would make up New Zealand’s second largest city,’’ says Michelle Thompson, RHAANZ chief executive.
To keep the industry healthy and growing, the people living and working in rural New Zealand must be healthy, she says.
RHAANZ recently trotted out a list of demands to the Government designed to bolster the health of rural communities – from improving internet speeds, to establishing a model to help those facing addiction and mental health challenges.
The rural school debate
Blueprints for a rural school of medicine – or a third medical school for New Zealand – have been in the pipeline for several years. The problem is, there are two sets of them.
The universities of Otago and Auckland released their joint proposal for a school that specialises in training for the rural health sector, after the University of Waikato and Waikato District Health Board revealed similar plans.
The tug of war will be decided by which one, if any, the Government decides to throw money at.
‘‘It’s a little unusual for universities to be going head-tohead,’’ Kelly says. ‘‘Waikato say ‘this is a straight out knee-jerk reaction’ and Auckland say ‘we’ve been working on this for three years’.’’
The Waikato proposal is being pitched as a regional solution to rural shortages – at least in its