There are about 1000 enrolled patients per GP in the Te Whatu Ora Lakes District, recently released Ministry of Health data reveals. Photo / 123RF
There are about 1000 enrolled patients per GP in the Te Whatu Ora Lakes District, recently released Ministry of Health data reveals. Photo / 123RF
Te Whatu Ora Lakes district’s GPs are outnumbered by enrolled patients by an average of about 1000 to one and one doctor says there could be thousands more unenrolled patients around Rotorua.
There are an estimated average of 1000 enrolled patients per GP in the Te Whatu Ora Lakes District, recently released Ministry of Health data reveals.
The data, released at the end of January, records primary healthcare enrolments according to the patient’s district of residence and primary health organisation records.
In total, the data shows there are 114,290 people enrolled with GP practices in the Te Whatu Ora Lakes District, 829 patients higher than at the end of 2019.
According to Healthpoint records, there are 26 GP practices and 107 GPs across Mangakino, Rotorua, Taupō and Tūrangi.
Dr Tim Malloy, the chair of GenPro, an organisation that represents GPs, said the recommended level was 1200 patients per fulltime GP but he suspected the numbers were “seriously” higher than that.
“It’s probably closer to 1500 per GP at an estimate and in rural areas around Rotorua probably about 3000 patients per GP.”
Malloy said while the number of enrolled patients reported to the Ministry of Health was probably accurate, Healthpoint’s records of the number of doctors in each region depended on updates from individual practices.
“We don’t have time to update Healthpoint,” Malloy said.
Genpro chair Dr Tim Malloy. Photo / Adam Pearse
Edgecumbe GP Dr Cecile de Groot said the important question to ask was how many patients there were per fulltime equivalent GP.
“In my experience many if not most of the GPs are working 0.8 FTE or less, some only 0.2. Many are also involved in non-clinical work such as research or positions with the PHO and Te Whatu Ora.”
De Groot said she did not have accurate figures but estimated in the Eastern Bay of Plenty some GPs could be working with more than twice the recommended number of patients.
“We’ve lost 18 GPs in the last 14 months alone with only two or three new ones coming to our area.”
De Groot said a GP’s workload was becoming heavier.
“Not only are we needing to see more patients in the allotted time but patients are more complex and demanding than in the past largely due to an ageing population, and also due to so many new treatments available for long-term conditions.”
On top of this, De Groot said GPs needed to deal with “unmanageable” inboxes of patient reports from different organisations, specialists and hospitals, sometimes receiving more than 100 in a day - a volume of emails that could take up to two hours a day to sort.
“Pressure on practices is immense. We are booking up to two weeks ahead, and are relying on nurses, nurse practitioners and health care assistants to manage patient requests in the meantime or turning patients away to be seen in ED or after-hours services.
“We have double and triple bookings sometimes for each 15-minute slot. This presents risk for patient and practitioner as it is not realistic to manage multiple issues in such short timeframes.”
De Groot said workforce recruitment, managing the expectations placed on GP practices, and improvements to health literacy were needed.
A shortage of GPs means some practices are turning patients away to be seen in ED or after-hours services. Photo / Andrew Warner
There are two primary health organisations based in the Te Whatu Ora Lakes District: the Pinnacle Midlands Health Network and Rotorua Area Primary Health Services Limited.
According to the data, there are 69,975 people enrolled with general practices under Rotorua Area Primary Health Services Limited.
As of the end of January, there were also 44,315 people enrolled with GPs in the Pinnacle Midlands Health Network for the district.
According to its website, Te Whatu Ora Lakes serves a population of just over 110,000 and covers 9570sq km.
Healthpoint’s records show there are 26 GP practices and 107 GPs across Mangakino, Rotorua, Taupō and Tūrangi.
Te Whatu Ora primary health care system improvement and innovation national commissioning group manager Adeline Cummings said the number of enrolments had increased since 2019 due to an increase in population.
“And, because of Covid-19, there has been a greater incentive to be enrolled at a GP practice.”
Cummings also said the number of GP practices had not changed since 2019.
“General practices may also close their books if they cannot safely take on any more patients, resulting in potential new patients being unable to enrol in a practice near them.”
Cummings said it was important to enrol with a GP so that when needed there was a trusted relationship in place for healthcare support.
“A general practice is a person’s medical home, where the record of all their conditions and medical history is kept.
“A person can get the best healthcare when they have continuity of care via an ongoing relationship with the same healthcare team, and when their full medical records are available.”
Cummings said general practices received funding from the Government to lower the cost of care.
“This means that an enrolled person will pay less for their appointment with a doctor or nurse. An unenrolled person is likely to be charged a higher casual fee for the cost of the consultation without a government subsidy.”
Access to subsidised prescription medicines, free healthcare for children under 14 and lower consultation fees for Community Services Card holders were three other reasons to enrol with a GP.
“Enrolment with a general practice allows a person to have access to comprehensive, subsidised, continuity of care from within their community, provided by a healthcare team who are well-trained and with whom a person can build a trusting relationship.”
