Health crisis: Northland patients in tears trying to get appointment with doctor

Just getting in to see a doctor causes anxiety and potential heartache, according to one Whangārei patient. Photo / 123rf

Northlanders say the inability to get a doctor’s appointment is impacting their health and leaving them anxious to ring their medical centre.

Health Minister Dr Shane Reti agrees it is difficult to get a general practice appointment and says primary health is a focus for him.

The health crisis was recently highlighted with Dargaville Hospital not having doctors overnight and Northland waiting lists blowing out in key areas such as cancer treatment.

But patients say those problems start with not being able to get an appointment with their general practitioner (GP).

One Whangārei woman, who spoke anonymously, said she struggles to get an appointment with her doctor for her post-traumatic stress disorder.

“I couldn’t get in to the doctor - I would be in tears on the phone in crisis,” she said.

“I know it’s mental health and that makes it hard because, technically, I’m not dying but I still need to see the doctor when I’m in crisis.”

While the patient was referred to White Cross when her need was urgent, the emergency clinic is unable to conduct the medication review she also needs.

In one incident, urgent care clinic White Cross referred the patient to Whangārei Hospital’s emergency department (ED) with a fast heart rate. She later found the ED doctor was looking at a medication list several years out of date.

The woman’s children have also had similar difficulties, being passed between their general practice, White Cross and ED without a diagnosis.

Reti, who is also Whangārei’s elected MP and a practising doctor, said primary care is a very high priority.

“I understand and agree - it’s the same for me - it’s very hard to get a general practice appointment, not just in Northland but all over the country.”

Health Minister and practising GP Dr Shane Reti says it is hard for him to get a doctor's appointment and there is a need to train more GPs in New Zealand. Photo / Michael Cunningham

A workforce plan for primary care will be released in coming weeks, with a focus on GP recruitment, retention and remuneration, he said.

Reti has already announced a 4% increase in capitation funding for general practices and the ability for them to charge their patients more to cover funding shortfalls.

The plan will include ways to increase New Zealand-trained GPs, with this year bringing the largest number of GP registrars.

International recruitment is also getting easier because other health systems are struggling, delivering “quality people” into New Zealand’s primary care environment, Reti said.

GPs will also be helped by other healthcare professionals, such as the way pharmacists are able to give immunisations, he said.

Patients will struggle with rising costs - GPs

But GP leaders say the system is so broken, the general practice funding model needs to be completely reviewed. An independent review into GP funding in 2022 by Sapere found high-need practices need a funding increase of 34% to 231% - multiples more than the 4% offered.

Coast to Coast Health Care chairman Dr Tim Malloy said he wants bipartisan primary care funding, so health does not continue to be a “political football” at the expense of patients.

Coast to Coast Health Care chairman Dr Tim Malloy says patients are suffering with delayed diagnosis of cancer due to the broken system. Photo / NZME

“The system is broken. It has a flow-on impact to [hospital] EDs and we’re seeing that now.

“There’s also later diagnosis for malignancy and a number of other variables that shouldn’t be happening in a modern health system, yet they are.”

Malloy said the problems are decades in the making and, while Treasury does not have all the money needed to fix the problem, patients can not afford to prop-up practices.

“There is a risk for our patients of inequity - those people who need it the most are going to struggle the most to access care.”

For very low-cost-access practices, such as Coast to Coast and many other Northland centres, enrolled adults with a Community Service Card will continue to be charged $19.50 an appointment, while those without a card will be charged $29.50.

But Malloy said the need is not always black-and-white, and there are plenty of patients struggling who are not eligible for a Community Services Card.

He also had serious concerns about the way doctors are trained in New Zealand and questioned why the number of medical students is capped each year when there are plenty of eligible students, as well as opportunities to train them in the community.

General Practice NZ chairman Dr Bryan Betty agreed low government funding will put the burden back on patients.

General Practice NZ chairman Dr Bryan Betty says an overhaul of general practice funding is needed for the sake of the whole health system.

A significant proportion of the population can not afford to pay their doctor’s visits, especially the likes of the working poor who do not qualify for all the subsidies, he said.

Betty also agreed there is a problem with a lack of doctors, with the country short about 400 GPs.

“Patients are right: they have real concerns over access - it’s a very concerning situation here.”

Betty said the whole funding set-up for primary care needs an overhaul, as it does not recognise the complexity of treatment, nor the sustained underfunding that has occurred.

He felt somewhat reassured that Reti is focused on implementing the recommendations of the Sapere report by 2026, but said urgency is needed for the sake of the whole health system.

“The problem for the New Zealand health system is if we don’t have accessible, quality general practice, then patients will access doctors through after-hours [centres] and ED, and late presentations will end up in hospital.

“We know, from all the research, it leads to very, very bad outcomes.

“Long-term, for the New Zealand health system, the idea would be to properly support primary care and general practice, so that those who need access can get in.”

Denise Piper is a news reporter for the Northern Advocate, focusing on health and business. She has more than 20 years in journalism and is passionate about covering stories that make a difference.