More than half of Northland GPs are reporting high levels of burnout. Photo / Matthew Kay
More than half of Northland GPs are reporting high levels of burnout. Photo / Matthew Kay
Northland GPs are burnt out and struggling with a lack of resourcing, despite Government promises to increase international recruitment and training.
A survey by the Royal New Zealand College of General Practitioners (RNZCGP) showed 55 per cent of Northland GPs suffered from high levels of burnout, compared to 48 percent nationally.
Whangārei GP Dr Geoff Cunningham said he was working up to 70 hours a week, with a major shortage of GPs in Northland.
He believes new doctors don’t want to go into general practice because of poor remuneration, and the current funding model disadvantages Northland practices, which charge less than average.
“Government funding doesn’t keep pace with inflation,” he said, also pointing out that fees GPs can charge patients are also controlled by the Government.
“You’re allowed to increase them at a level lower than the practices around the country that have higher fees. It’s percentage-limited so if you’re a practice charging $60 you can put them up more than a Northland practice charging $30 or $40.
“The funding system’s beyond broken and punishes practices like ours, regions like Northland, disproportionately.”
There are also low numbers of GPs in training and large numbers intending to leave the profession soon, Cunningham said.
“This must be turned around, it’s just critical. General practice is the cornerstone of the healthcare system.”
The RNZCGP survey showed 46 per cent of Northland GPs planned to retire in the next five years - the second highest proportion in New Zealand.
Dr Geoff Cunningham says GPs in Northland are disadvantaged by the current funding system. Photo / Michael Cunningham
Cunningham said patient care was suffering due to the lack of GPs and a stretched workforce.
“And that’s soul-destroying for GPs. We’d love to be working in a better-resourced system but that doesn’t appear to be a priority.”
Although he still loves his job, Cunningham said GPs are now suffering from “moral injury” due to the undermining of the profession by the Government.
The Government’s refusal to give general practice nurses pay parity was also an issue, leading to many leaving for roles outside general practice, Cunningham said.
General Practice Owners Association (GenPro) chairman Dr Tim Malloy said there were a number of reasons for burnout, but resourcing was a major issue.
“You can imagine if you really need half an hour for a person because they’re so complicated but you can only give them 10 minutes, then that creates a stressor on the doctor.
“They feel they’re letting them down but if they don’t get on then the next patient is going to get let down.”
Underfunding has been a problem in Northland for some time, Malloy said, as has the shortage of staff.
“For 25 years I’ve been telling successive governments we have to train more of our own [GPs] and for 25 years they’ve ignored it because of the upfront cost of doing so,” he said.
Malloy said his own Coast to Coast Healthcare, which has practices in Kaipara and Rodney, had done well with recruitment but it was difficult.
“We have worked aggressively on recruitment for a very long time but like everybody else around the country, we struggle to both recruit and retain the doctors we’ve got.”
Coast to Coast Health Care general practice co-owner and GenPro chairman Dr Tim Malloy. Photo / Adam Pearse
They also have seven doctors over the age of 65 who have not yet retired because they are needed, Malloy said.
RNZCGP president Dr Samantha Murton said the funding for GPs did not reflect work doctors did outside of appointments with patients.
“We’d love to do a really good job for all our patients, especially our high-needs patients, but we have this vanilla formula for how we provide care and how we finance it.”
Part of the issue had been dealt with by changes brought in last year to compensate practices for training junior doctors, Murton said.
The Wellington-based GP said her “heart goes out” to her Northland counterparts struggling with major staff shortages.
“There are many pockets around the country where they’re desperately short and where those places are desperately short we need to come up with some radical changes to make it better.”
Minister of Health Dr Ayesha Verrall said she had met with a number of GPs, including at six round table events since becoming minister, and was “very aware” of their concerns.
“There is a lot of work to be done, and many opportunities to partner with them as we create a better public health system.
“Workforce is one of my top three focuses, along with winter and reducing waitlists.
“To date we have a number of pipeline workforce initiatives under way such as the New Zealand Registration Examination (NZREX) Primary Care pathway for international GPs, the recently established International Recruitment Centre and new health immigration service.
Verrall said Te Whatu Ora was working with RNZCGP to increase the number of GPs trained per year to 300 by 2026, with a focus on growing the number of Māori and Pacific GPs.
“This includes an increase in the salaries for GP registrars, and Te Whatu Ora will pay a hosting fee of $3600 (excluding GST) per placement to general practices that offer community-based attachments for post-graduate year 1 and 2 doctors from 2023.
“This will help promote general practice as a vocational choice.”
