Editorial: The GP crisis and the patients left out in the cold in the early hours

EDITORIAL

“They are already sick. They get more unwell sitting out here in the cold”.

That was how community liaison manager Lorenzo Kaisara described patients queuing at 6am outside Ōtara‘s Local Doctors and Urgent Care.

As the Herald’s Michael Morrah revealed this week, patients in one of New Zealand’s most impoverished communities are so desperate to see a doctor that they’re lining up outside in the cold hours before the clinic opens its doors.

Tāmaki Health owns the clinic and its chief executive, Lloyd McCann, described the situation as “absolutely heartbreaking” and “gutting”.

McCann told the Herald the queue outside the Ōtara clinic was a symptom of the “significant challenge” general practice is facing.

“It’s absolutely heartbreaking. We don’t want our patients, our communities, experiencing this. People are desperate to access healthcare,” he said.

Ōtara’s Local Doctors and Urgent Care is by no means the only clinic struggling. Here are more examples from the last few months:

• Kaitāia residents are having to travel long distances, sometimes as far as Auckland or even Tokoroa, to see a doctor due to a severe shortage of GPs in the town.
• Waihī Medical Centre, which has 4000 patients, is relying on locums and virtual GP services after its permanent GP left near the start of August.
• A Rotorua GP was working between six and 12 hours on her evenings and weekends, with workload demands taking a “huge toll” on her.
• A GP practice in Lower Hutt has stopped doing face-to-face consultations, except in urgent cases.
• A Pāpāmoa GP clinic that serves 6000 patients closed in April, with its co-owner saying it is “absolutely not viable anymore” due to the doctor shortage and government underfunding.
• Tairāwhiti Three Rivers, which has 20,000 patients, will close its books to new patients and no longer open on weekends and public holidays.

This is not a sign of a system in good health. And like patients waiting in the cold to see a doctor, clinics closing their books or shutting down due to financial pressures will only make an ailing system get worse.

Dr Angus Chambers, chair of the General Practice Owners Association, said a number of after-hours services, including in Auckland and Christchurch, are stopping or reducing their services.

“The drip is turning to a trickle, which threatens to become a torrent,” Chambers says.

“Urgent care, the most expensive service to deliver and most difficult to staff, is therefore the canary in the coal mine, and signals the beginning of wider service closures.”

Health Minister Dr Shane Reti claims the Government is responding.

Reti acknowledged “long-standing” pressure on primary care and said solutions for GPs and patients relied on recruiting and retaining more doctors and improving remuneration.

He also pointed to 25 new training places for GPs, the creation of a business case for a third medical school and says close to 230 GP registrars will soon complete training, the largest-ever cohort to do so.

But that isn’t the shot in the arm which our GPs say they desperately need to address a “history of chronic underfunding”.

Unless more is done, expect to see more people out in the cold next winter and more clinics struggle to give patients the help they need.