Dialogue: Memo to GPs: it's not the end of the world up here

By TONY GEE in the Far North

Wanted: at least three general medical practitioners for work in the Far North.

Qualifications: must be experienced and registered in country of origin and be prepared to work in diverse, semi-rural community.

Salary: packages by negotiation. Terms of two years or more preferred.

Family: education for children to university bursary level. Some tertiary courses also available. .

Benefits: Restaurants. Shopping. Banks still available. Rostered time off to enjoy attractive outdoor lifestyle not normally available year-round in applicant's country of origin - fishing, diving, boating, swimming, surfing, golf, tennis and so on. Huge potential for coastal and rural property investment.

Please note: New Zealand GPs need not apply.

That sort of advertisement, with a few refinements, is one the greater Kaitaia and northern Far North community should be considering placing in overseas newspapers.

It's likely to be the only way to ensure that more than 22,000 people continue to have access to a level of primary medical service they have come to rely on.

The pitch has worked in past years. Visit a GP in Kaitaia, or on the east coast's Doubtless Bay, and you're more than likely to hear a North American, South African or other foreign accent.

There is nothing wrong with that, because quite simply the northern Far North and other similar small-town communities throughout the country can't seem to attract and retain younger New Zealand doctors.

The reasons are clear enough. Bigger salaries, more opportunities and more doctors to share workloads are all on offer in big cities here and overseas, and no one can really blame graduating New Zealand GPs for taking up those seemingly more lucrative and exciting challenges.

The major problem for small-town areas like the Far North is one of perception - that for resident GPs it's all work and no play, with constant on-call pressure and no time off.

No one disputes that such doctors work hard for long periods. That's part of their job, just as it is for city GPs.

Providing 24-hour coverage on occasions, by a GP or a member of his or her practising partnership, is required under health legislation.

There is an in-built expectation that long hours will have to be worked as and when required.

In the Far North, there is now a perception that a handful of family doctors (there will be six GPs left in the area when 36-year Kaitaia veteran Dr Tom Young retires on March 30) will be left to struggle on by themselves if no one else turns up to share the burden.

This, in turn, fuels the fear that some of those remaining GPs might also join the exodus in despair.

More money and intervention by the Government is not a long-term answer, even if the Government, through new district health boards, were able to throw more funding at gaps in rural GP ranks.

You can't make a doctor, or anyone for that matter, go to work anywhere they don't want to be. Neither can they be encouraged by inducements if a particular area holds no appeal.

There's also the spouse or partner factor, again largely perception-related. A GP's partner must also be comfortable living in an area, not worrying about a perceived lack of good educational opportunities for their children or an absence of high-quality boutiques.

And that's the Far North's problem. Too many people, especially New Zealanders - and GPs are no exception - think Kaitaia, and other small communities, are the end of the world.

"They don't know what they're missing. In general, GPs in communities like these have a pretty good lifestyle," one doctor said recently.

This month, one GP remaining in Kaitaia urged the local community to start taking ownership of the town's looming doctor shortage problem.

He called on people to put their heads together and come up with a community solution to what he saw as a community problem.

So far so good, in theory.

But if a community-based trust or some other type of local health initiative aiming to get more GPs into Far North surgeries does get off the ground, it should first consider how to overcome the perception problem.