Health New Zealand Lakes: Where the ratio of GPs to population is 1900 to 1

The Health New Zealand district that covers Rotorua and Taupō has 63 general practitioners for a population of about 120,100.

Based on these numbers, published in a recent Medical Council workforce survey, Health NZ Lakes has a ratio of 1900 people per GP, not all of whom work fulltime.

But amid the workforce crisis facing the primary care sector, Taupō's third and newest general practice is “revitalising” its GPs’ passion for the job.

Wellspring Medical co-founder Dr Natalie Clarke said she and Dr Vanda Nobre had experienced the “magnitude of burnout” affecting health workers.

“We had to pivot and come up with a way to protect our patients, ourselves and our staff from the difficulties that we face in the system right now,” Clarke said.

“We’ve lost sight of the importance of team wellbeing and individual wellbeing because of the lack of GPs and other healthcare providers in primary care.

“If we can’t be well in ourselves, we can’t look after others.”

Wellspring Medical opened on the ground level of 108 Tūwharetoa St in October last year.

Clarke and Nobre, neither of whom work fulltime, aimed to keep the practice small.

They limited their patient ratios to the Royal New Zealand College of General Practitioners recommendation of one full-time GP to a maximum of 1600 patients.

Wellspring Medical was opened on October 24, 2023 by Dr Natalie Clarke (left) and Dr Vanda Nobre.

Four months after opening, the practice had 1200 patients.

Just over a year later, Wellspring Medical has a patient panel of 1500, with 200 on the waiting list.

The numbers allow them to offer longer appointments and lower wait times.

“The reward has come from the patients and their feedback,” Clarke said.

The first year of the clinic’s operation has “surpassed” all her and Nobre’s expectations.

“It’s generally a very friendly and light place to work. We try to make the atmosphere as approachable as possible.”

Clarke said patients and staff enjoyed the relaxed and supportive environment.

“Every patient who enrols with us has an onboarding appointment that is comprehensive about their wellbeing,” Clarke said.

“They meet a nurse, a GP and they get to know our entire team. They know who they are going to be seeing and it sets the stage for the experience to be more comfortable.”

Taupō has three general practices.

Clarke said that as patients’ “complexity” increased and as she saw patients who have been disenchanted by the system, establishing that relationship before getting to the “medical aspects” was important.

“Patients appreciate being heard, being able to connect and feel safe.”

Clarke said setting up and working at Wellspring Medical has “extended” her career.

“It’s revitalised my passion for medicine being able to connect with patients again.”

Clarke said looking after the team’s needs helped to provide better healthcare to their patients.

“We’re not going to be able to fill the GP deficit immediately. We are going to need a different approach.”

Clarke said building patients’ relationships with other staff at the clinic and wider primary care network also helped meet patients’ needs.

“Our Taupō/Tūrangi primary care community shares the Pinnacle extended care team, which includes nurses, dieticians, exercise consultants, health coaches and health improvement practitioners.”

Clarke said relying on GPs alone was “not working”.

“This team approach to healthcare represents the type of collaborative network that is rooted in promoting both health and wellbeing.”

Number of GPs drops to below 25% of all doctors in the country

Te Kaunihera Rata o Aotearoa, the Medical Council of New Zealand’s 2024 Workforce Survey showed the proportion of GPs has dropped to below 25%of the country’s doctors.

From 1980 to 2000, GPs accounted for 40% of New Zealand’s doctors.

The survey showed that in Waikato, there were 390 GPs for a population of 458,600.

Waitaha Canterbury had the highest number of GPs: 572 forabout 602,000 people.

Nationally, GPs worked an average of 44.6 per week. However the average work hours varied from 49 per week in Te Toka Tumai Auckland and 37.8 in Te Tai o Poutini West Coast.

Dr Angus Chambers is the chair of the general practice and urgent care provider association GenPro. Photo / George Heard

Dr Angus Chambers, chair of the general practice and urgent care provider association GenPro, said the numbers reported in the survey did not accurately capture workforce pressures affecting GPs.

“The report tells a story of a static number of GP doctor hours with a growing and ageing population who require significantly greater input,” Chambers said.

“[This] is starting to significantly impact the ability of the GP workforce to meet the health needs of our communities.”

Ministry of Health chief medical officer Dr Joe Bourne said the declining proportion of GPs in New Zealand was consistent with other countries.

“[It] sits alongside increasing specialisation within the medical workforce.”

Bourne said workforce shortages in primary care made it harder for some Kiwis to access health care in their communities.

“General practice is the foundation of our health system and GPs work as part of a healthcare professional team.”

Bourne said primary care, including GPs, played a critical part in supporting the Government’s focus on prevention and early intervention.

“Increasingly, primary care is provided in multidisciplinary teams with different health professionals working together.”

Bourne said the ministry and Health New Zealand’s efforts to strengthen the sector included the establishment of a proposed new medical school in Waikato and 25 more medical school places a year in Auckland and Otago.

Ministry of Health chief medical officer Dr Joe Bourne.

Health New Zealand Te Whatu Ora interim chief human resources officer Fiona McCarthy said Health New Zealand was committed to promoting sustainable, domestic growth in the number of GPs trained and retained in New Zealand, “but this takes time”.

McCarthy said Health New Zealand aimed to increase the number entering GP training annually by up to 300 by 2026.

“We are working with the Royal New Zealand College of General Practitioners to promote the GP training pathway.”

McCarthy said steps had also been taken in 2022 and 2023 to improve GP training.

Maryana Garcia is a Hamilton-based reporter covering breaking news in Waikato. She previously wrote for the Rotorua Daily Post and Bay of Plenty Times.