“Overwhelmingly disappointed”: Government funding for frontline community health workers leaves out GP staff

Te Oranganui mātaiwhetū/chief executive Wheturangi Walsh-Tapiata. Photo / Bevan Conley

As the Government announces funding for frontline community health workers, nurses and GPs around the region are “overwhelmingly disappointed” they have been left out.

“Our nursing team are devastated by the news,” Ruapehu Health clinical service manager Tracy Mitchell said.

“They’ve been holding out for better pay and their passion for primary care and looking after our rural community is really evident.”

On Monday the Government announced $200 million a year would go towards boosting the pay of frontline community health workers to ensure there is parity across the sector.

But nurses and doctors in general practice clinics were not included.

“Imagine if you’re a small rural clinic with maybe one GP and two or three nurses,” Te Oranganui chief executive Wheturangi Walsh-Tapiata said.

“All you need is for one of them to leave to dramatically impact the ability of the clinic to service that community.”

The funding would affect an estimated 20,000 people nationwide who will get a pay rise, and the organisations employing them, which have struggled to keep staff when they can’t afford to pay as much as Te Whatu Ora Health New Zealand.

Contract changes were expected in those places from the first part of next year, followed by mental health and addiction facilities, organisations caring for the disabled and other types of residential care, and then other government-funded health services.

Health Minister Andrew Little said data provided by both the Nurses Organisation and the GPs’ organisation GenPro for that sector did not show any real evidence of pay difference at this point.

“The funding is ongoing, though, and that decision could change if evidence of disparity emerges in the future.”

Aged-care facilities, hospices, home care support and Māori and Pacific healthcare organisations would be first because there was evidence that was where the biggest pay gap was, Little said.

“I expect these contract changes will happen in the first part of next year, followed by mental health and addiction facilities, organisations caring for the disabled and other types of residential care, and then other government-funded health services.”

He said many of those workplaces had been struggling to retain staff because they could not pay as much as Te Whatu Ora.

Health minister Andrew Little said aged-care facilities, hospices, homecare support and Māori and Pacific healthcare organisations would be first because there was evidence that was where the biggest pay gap was. Photo / Mark Mitchell

Mitchell said GPs and nurses everywhere were working tirelessly.

“I’ve done primary care working for 28 years now, and we’ve always been thinking one day we’ll be paid better.”

Walsh-Tapiata said GPs missing out on the funding could impact further the retention of staff who would be attracted by bigger salaries outside of the general practice.

“It could also significantly impact rural clinics.”

Walsh-Tapiata said although the Government said it would address the pay at GPs in the next six months, backpay would be needed if pay was increased so there was parity across the board.

“GPs don’t earn the same amount doctors do in hospitals, and organisations will have to adjust their salaries no matter what in order to keep the staff.

“In the community, we’re funded purely by state funding, so where does that extra money come from?”

She said it would have to come directly from the organisations.

“We are constantly having to juggle the ball about how we retain staff and commit to their professional development so they continue to learn and grow.”

“The 2022 Budget did detail they would address the funding for general practice, so there is a commitment to do that,” Whanganui Regional Health Network chief executive Jude MacDonald said.

“What this does create though is even more pressure on the general practice teams to hang on to their workforce.”

She said the result would be general practice would become less attractive to workers in the short-term before any review took place.

“Reviews are fairly complex and don’t happen quickly, and my concern is if we don’t get an outcome from the capitation general practice funding review for another nine months then it will have a significant impact on our workforce availability.”

MacDonald said if the staff’s driver was money, they would likely leave general practice to seek other roles that pay them more.

“We’re in the middle of a cost of living crisis and money is an important leader for change.

“The danger is we are already under pressure because we don’t have enough workforce, with doctors retiring and reducing their hours, and demand and access to general practice will get worse.”

Whanganui Regional Health Network strategic manager in charge of rural practices Janine Rider said during the Covid-19 pandemic, primary care and iwi providers were asked to step up and keep people out of the hospital.

“And all the reforms are talking about community and primary responses, and yet that’s where the minister hasn’t shown any evidence of commitments through financially reimbursing that workforce,” Rider said.

“The reforms are all talking about putting the services in the beginning and then you take the pressure off where the highest point of cost is, and yet it does appear when we look at our remuneration it’s not considering what the early stage of prevention might look like as best as it can.”