Primary care’s representative on national health service Te Whatu Ora’s board believes investment in workforce and infrastructure is the key to realising the future of healthcare he predicted three years ago.
Toward the end of 2019, Wellington GP Dr Jeff Lowe spoke before leaders of New Zealand’s health system, laying out his predictions concerning what healthcare might look like in five to 10 years’ time.
They included general practitioners becoming more accessible through new channels, alternatives to face-to-face consultations, shoring up care pathways through hospital and community providers, freeing up siloed specialist knowledge and seeing a return of the “joy of working” for burnt-out practitioners.
Little did he know that only months later, Covid-19 would land on New Zealand shores and would bring about much of the changes he foresaw but in a much shorter timeframe.
“Probably three or four months later, I recall sitting in the Royal College of General Practitioners office, thinking, ‘We’re going to have to go to virtual consulting by Monday’ and we were discussing this on the Saturday,” Lowe said.
“What Covid did is it pushed that whole agenda forward, five to 10 years.”
Lowe, alongside former Inland Revenue Commissioner Naomi Ferguson, is the latest addition to Te Whatu Ora’s (Health New Zealand) board that will oversee the public health sector’s transition from 20 separate district health boards to one national body.
Three of the eight-person board have medical qualifications and Lowe would be considered the sole voice from primary care as a GP with the Karori Medical Centre.
His appointment comes amid a growing GP workforce crisis that included increasing levels of burnout and a worrying number of practitioners that intend to retire in the immediate future.
In response, Health Minister Andrew Little announced last month the number of GPs trained in New Zealand each year would increase from 200 to 300, as well as installing pay parity for GP trainees and their counterparts in hospitals.
Lowe supported the announcements but noted vision should be broadened from just addressing GP numbers.
“We certainly need more GPs, but we also need to look at the wider workforce and who works within the general practice team, because primary care is a team sport,” he told the Herald.
He made particular reference to the kaiāwhina workforce, a non-regulated position that became essential to New Zealand’s Covid-19 response in facilitating mass testing and vaccination.
The kaiāwhina role was a key topic during Saturday’s first-ever workforce dialogue, attended by about 160 health professionals and hosted by the Ministry of Health at Parliament.
Despite some feeling sceptical of calls for change after past promises to promote primary care, it was understood there was optimism in the crowd following Saturday’s discussions on what issues plagued the sector.
Lowe recognised the importance of his role on Te Whatu Ora’s board.
“I hope [my appointment] gives [GPs] the sense that there is a voice being heard at a national level and I certainly intend to use it to the advantage, not just of general practice and primary care, but for the advantages of the whole of the system.
“Without blaming any particular period or government, there has been an erosion of the investment in primary and community care, and that’s something that needs to be addressed.”
Lowe wouldn’t elaborate on what specific investment he felt was necessary, except to reference the need for pay parity between staff who worked in the community and their hospital colleagues.
“Our biggest issue currently is workforce, that is an international problem so we are not alone,” he said.
“Whilst the workforce would appear to be under stress and somewhat burned out, I still see hope within the workforce.
“My fear is that if we don’t do something soon, particularly within primary and community, we will lose that hope and it’s a long way back.”