Rural communities now struggling to access equitable healthcare

Surgical buses like this have filled some of the healthcare gaps across the country but is it enough? Photo / File

COMMENT

New Zealand Rural General Practice Network chief executive Dalton Kelly warns that a foundation of our rural communities – the ability to access healthcare – is now under serious threat.

Recently we've seen junior doctors and teachers both taking extensive strike action for better conditions. It's inconvenienced a lot of people – operating schedules have been disrupted, procedures delayed, rosters shuffled, costs incurred, parents forced to take leave, childcare arrangements thrown up in the air.

If rural healthcare providers were to take the same action, it's likely there would be catastrophic consequences. That's because there are fewer and fewer doctors in our rural towns and provinces – to the point that for many doctors, taking a day out of the clinic leaves an entire community with no doctor.

Most recently this has become a pressing issue in Northland, but much of New Zealand is heading in the same direction.

Given rural New Zealand is the heart of our economy, Kiwis must pay real attention to what threatens our rural communities. I believe the biggest threat to rural New Zealand is now the lack of equitable access to healthcare.

New Zealand is in the middle of a significant rural health crisis. It has been coming for some time and is now only going to get worse before it can get better.

The New Zealand Royal College of GPs recently released its annual workforce survey. It makes for grim reading if you live rurally and care about your family's ability to access healthcare.

Many rural communities are admirably looked after by a long-serving GP. They're almost certainly the cornerstone of their local communities, literally providing cradle-to-grave services for entire families over generations. However, for those rural communities that are not already struggling with a chronic GP shortage, it will not be far away for many.

More than half of all GPs are over 52 years old. More than one third of GPs intend to retire in the next five years and 57 per cent in the next 10 years. The forecast retirement rates for rural GPs is even higher than for their urban counterparts.

Almost 40 per cent of rural general practices are already reporting an unfilled GP vacancy. Rural communities are twice as likely to be relying on short-term employees or contractors compared to urban centres. Almost half of all rural GPs are now international doctors that have graduated in other countries before moving to New Zealand.

Unsurprisingly, on top of these statistics, more than a quarter of all GPs (urban and rural) are experiencing burnout and our concern for the mental and physical wellbeing of rural doctors continues to increase. Rural GPs are working longer hours than urban GPs and three quarters of rural GPs are providing after-hours and emergency care.

Yes, we're training more doctors than before and that's a good thing. But they're not going to work in rural New Zealand. There's more than enough work in the urban centres where they have trained, met their partners, formed friendships and started families.

We must follow the Australian example and start to train our next generation of health professionals inside our rural communities. If they're trained inside rural communities, they're much more likely to meet their partners, make friends, and start families there. They're much more likely to stay in rural New Zealand.

The only positive in this rural health crisis is that the Government shares our vision for turning it around. The Health Minister has announced a commitment to the first of a number of rural health training hubs – multidisciplinary training centres where our next generation of doctors, nurses, midwives, physiotherapists and pharmacists can all be trained inside and as a part of a rural community.

On behalf of New Zealand's rural doctors and nurses we also strongly support the idea of a National Rural Health Commissioner for New Zealand, again as has been successfully implemented in Australia.

Tackling our rural health challenge will require bringing together many parties – doctors, nurses, hospitals, universities – as well as the communities at the front-line of this challenge. We think a National Rural Health Commissioner can provide the leadership and co-ordination that successfully addressing this issue is going to take.

In the meantime, communities such as in the Far North are facing month-long waiting times just to see a doctor and existing clinics are unable to take on more patients, despite pressing health needs within the community. Our rural communities must not fall into the trap of blaming its doctors for this situation but must join with its healthcare professionals in demanding solutions that preserve the right for rural people to equitable health care.

As we celebrate all that rural New Zealand contributes to our country and economy, that is not too much to ask.

• The New Zealand Rural General Practice Network is the membership-based organisation representing almost every rural medical practice in New Zealand. It also represents the New Zealand Rural Hospital Network and Rural Nurses New Zealand.