Ōtaki Medical centre chief executive Kiw Raureti has six overseas-born GPs. Photo / Mark Mitchell
Amid a pandemic and a nationwide GP shortage, a regional medical practice that struggles to recruit domestically says it should be "seamless" for migrant doctors to enter and stay in New Zealand.
The report found 50 per cent of the country's GPs planned to retire in the next eight years, on top of an overlying shortage: New Zealand has just 74 GPs per 100,000 people, compared to Australia's 120.
On top of this, GPs are facing surging demand amid the country's Omicron outbreak, with workplaces hampered by Covid infections and isolation requirements.
Earlier this week, Primary care lead Dr Joe Bourne said GP practices were continuing to see increased demand, up 15 per cent on last year, with some regions seeing increases of up to 30 per cent.
General practitioners are currently on New Zealand's long-term skill shortage list from Immigration NZ.
Ōtaki Medical Centre chief executive Kiwa Raureti finds it "next to impossible" to find Kiwi GPs willing to move to the region, and currently has five overseas-born GPs, with another due to arrive next month.
"All the normal processes you have for hiring a GP, they just don't work," he said.
"So you've got to think outside the box and find a different way of doing things to attract GPs, including how we advertise and market overseas.
"We tend to pay above the average because that's what we've got to do to get them here. And then if they're from overseas we just have to hope and pray Immigration NZ are going to let them in."
For Ōtaki's Māori population, Raureti said he would like a Māori GP at the medical centre, or at least a New Zealander with experience with kaupapa Māori.
"Those are the two ideals we're trying to do, but I'm finding that next to impossible, which is why I've got to go overseas.
"And even when I go overseas it's been really hard getting them here and when I've recruited from overseas, it's really hard to keep them here.
"I've been really lucky to get the doctors that I have – but that's just been luck."
The biggest barrier was not attracting migrant GPs to the region, but getting them into the country and on a pathway to residency, if that's what they wanted.
Their most recent new GP had his spot in MIQ twice delayed as he was not considered an essential service, Raureti said.
"Every morning he was getting up in Holland, or when a ballot became open he was on it trying to secure a place," he said.
"It was really hard for him to get here, I was actually quite surprised he carried on trying to come.
Emails revealed to the Herald showed the young GP had repeatedly requested a meeting with the Associate Immigration minister Phil Twyford to plead his case to be considered for residency.
An email from Twyford's office at the time said the minister would not be considering any requests and the deferrals were a temporary measure in responding to the Covid-19 outbreak.
Raureti said the Government needed to make New Zealand and its residency process more attractive to young GPs, irrespective of Covid.
"We need for GPs overseas to know that Destination New Zealand is a good location for a career," he said.
"Part of that is they need to make it an easy seamless process for people to get here, and then once they're here an easy process for them to stay – and that's not the case at the moment."
MBIE Immigration (Skills and Residence) policy manager Andrew Craig said general practitioners are currently able to enter New Zealand through the Critical Healthcare Worker border exemption pathway.
"Everyone entering New Zealand through this pathway is eligible for the 2021 Resident Visa, a one-off residence pathway for around 165,000 onshore migrants.
"General practitioners who were already in New Zealand before our borders closed are also eligible for the 2021 Resident Visa.
"General practitioners were also prioritised under previous Skilled Migrant Category and Residence from Work residence visa processing.
"Recruiting is still an issue for us – bringing doctors in from overseas – and keeping them in will be an issue, Covid or not."
The Royal New Zealand College of General Practitioners medical director and Porirua GP Dr Bryan Betty said New Zealand had become dependent on overseas-trained doctors to fill the shortages.
"Over the last couple of years obviously the tap's been turned off with immigration due to Covid and that's really started to bring these problems to the fore," he said.
This had exacerbated the underlying shortage of GPs that was already there, he said.
"If we add that to the report the college released which shows that over the next eight years, before 2030 50 per cent of GPs have indicated they're either going to cut back or retire, on top of an overlying GP shortage."
Pre-pandemic there had been schemes to bring skilled GPs into New Zealand, but these had also been fraught with capacity issues in DHBs that could provide supervised training, and had all but "dried up" due to Covid.
Betty said the re-opening of the border, freeing up movement of the skilled medical workforce, was a positive thing.
"Things like the Rural GP locum scheme can get back up to full force again to try and facilitate and encourage doctors to come in."
But Betty said New Zealand also needed to address its GP shortage at home, with a shortfall of at least 100 GPs a year being trained in the country.
"Forty per cent of our graduates should be choosing general practice so we can maintain and grow our workforce, but at the moment we've got only 20 per cent indicating they will do that.
"If we look at the GP training scheme, we're training less than 200 a year. This year it was 195 ... we need about 300 a year to be trained to maintain our numbers."
It was a complex set of factors that contributed to the low numbers of doctors going into general practice.
"It's exposure to general practice in those undergraduate years and those first years out, there's issues around the differentials in pay, and there's issues in the recognition of their training once they come out the other end.