The backbone of New Zealand's health system was general practice, health experts believed. Photo / NZME
The Bay of Plenty is feeling the effects of a general practitioner shortage that is "reaching crisis point" around the country with people having to wait up to two weeks for an appointment.
This week The Doctors Bayfair was forced to close its walk-in clinic citing a GP shortage in an online alert.
The Doctors regional nurse manager Wendy Dillion said one doctor being sick meant the walk-in clinic could not go ahead, however, pre-booked appointments were not affected.
"There is a GP shortage across our Bay of Plenty medical centres which is not limited to our network.
"Winter is always challenging with more people needing medical care and health practitioners becoming unwell. We have noticed the GP shortage growing significantly in the past five years and it is reaching a crisis point."
Dillion said the practice aims to see patients for a routine appointment within three days of a booking, but patients can be waiting two weeks.
The Bay of Plenty is no different to any other region when it comes to a GP shortage but it does fare better than other provincial centres and the rural sector, according to Western Bay of Plenty Primary Health Organisation clinical director Dr Andrew Corin.
Burnout among GPs has jumped to 30 per cent of the workforce, up from 22 per cent in 2016, according to a recent Royal New Zealand College of General Practitioners survey.
In the Bay of Plenty District Health Board area, more than one-third of GPs scored between 7 and 10 on the burnout scale, reflecting a national picture of stress in primary care.
The same survey found almost one-third of general practitioners across the country intend to retire within the next five years and almost half intend to retire within the next 10 years.
Corin believed other problems were exacerbating the issue in the Bay of Plenty.
"The GP shortage is combined with an increase in demand for primary care services from an ageing population with complex healthcare needs.
"Underinvestment in training GPs in the 1990s has also negatively impacted the number of middle-aged and experienced GPs who will remain working beyond the next decade."
PHO practice services general manager Phil Back said the shortage was resulting in practices closing their books to new patients, which then affects equitable health.
"People may have to find a practice further away from their home or workplace.
"The Bay of Plenty has a significant Māori population for whom these constantly changing situations can impact their access to timely healthcare and equity of health outcomes."
Traditionally the shortage never affected Tauranga because health care professionals were attracted to the idea of living in the Bay, said Fifth Ave Medical Centre general practitioner Dr Luke Bradford.
"Up until probably Covid, we were quite well served."
Aside from border restrictions and the waiting game for trainees, Bradford believed there was also an increasing demand for services that was stretching the sector too thin.
"A lot of it's to do with mental health but some of its the fact that now everybody gets everything checked.
"We are inundated at the moment with small children coming through the doorway who have snotty noses. But small children live with snotty noses, that's part of being a small child."
Keeping up with the acute demand meant GPs were falling behind in long-term care, Bradford said, and he believed the vicious cycle would only continue until resourcing for primary health in the government's health reforms were announced.
More worryingly, Bradford said if patients weren't receiving their preventative medication or their long-term conditions and chronic illnesses managed, hospitals would fill.
"If you don't have a functioning and delivering primary care system, then you will have massive surge demands on the rest of the health system."
"The healthcare system as a whole, including GP surgeries and hospitals, is currently experiencing very high levels of demand and several factors feed into this, including that of a continuing local population increase."
Royal New Zealand College of General Practitioners medical director Dr Bryan Betty said the shortage was "reaching crisis point" driven by burnout, underinvestment and reliance on overseas graduates that couldn't get into the country because of border closures.
Betty said 40 to 50 per cent of the workforce were overseas trained.
"We're very reliant on overseas graduates in New Zealand and obviously with Covid that has dried up a supply of doctors coming into the country."
Primary health organisations are funded by DHBs to deliver primary health care, mostly through general practices.
Betty was hopeful upcoming health reforms would hold good news for what he believed was the backbone of the health system.
"The funding structure does need to be thought about very hard. Patients with multiple comorbidities need to be dealt with in a slightly different way within the system - certainly, the profession is asking for a review of what is happening in this space.
"The backbone of the medical system in New Zealand is general practice and frontline medical care and if it's under-resourced, there's absolutely a problem."
Bay of Plenty was experiencing a shortage because "nowhere is protected", said New Zealand Medical Association general practice council chairwoman, Vanessa Weenink.
"How long can you be in a crisis before it becomes normal and accepted?
"Part of the problem is we have been in a crisis for the past five years and we're limping along. Nothing has completely fallen apart, but we're not employees so we cannot go on strike or negotiate for pay and conditions as hospital doctors do."
Weenink said there was no short term solution to what she described as a complex issue.
"I think one thing that would help is patients understanding the situation because what adds pressure to an already overworked and stressed workforce is feeling like we're not serving our patients who we genuinely love and want to look after."
'You don’t want to be doom and gloom your whole life. That's just a miserable way to live'