Rural General Practice Survey: A Growing Threat To Access To Appropriate Health Care For Those Living In Country Areas

Hauora Taiwhenua has collated its 2024 Rural General Practice Stocktake Survey; collecting critical data to measure the current operational status, challenges, and morale across New Zealand's rural general practices. This initiative aims to provide a comprehensive, evidence-based view of key indicators affecting rural healthcare.

Conducted in June to July 2024, the survey achieved a strong 54% response rate, with 103 of New Zealand's 190 rural general practices—identified under the Primary Health Organisation Service Agreement (PHOSA) and classified using the University of Otago's Geographic Classification for Health (GCH)—contributing their insights. Representing GCH R1-R3 areas, the responses mirror the rural population distribution, with the surveyed practices collectively serving 46% of rural New Zealanders.

Hauora Taiwhenua’s Chief Executive, Dr Grant Davidson, notes the importance of this initiative, stating, “Rural general practice is the backbone of health and wellbeing in rural communities, sustained by healthcare professionals who bring expertise, energy, and an unwavering commitment to their communities. The survey findings show that a shortage of workforce, including 130 ‘missing’ doctors, is leading to practices closing books to new enrolments, reducing or removing hands-on after- hours services and reduction in training health students in their practices. This underscores an urgent need for financial and workforce support to ensure rural communities can access healthcare close to home.”

Key survey reflections reveal a critical state for rural general practice. Staffing shortages, under-investment, and an increasing burden on facilities continue to impede the recruitment and retention of healthcare workers. Coupled with a reduced capacity to provide off-site, out-of-hours care and onboard new patients, these constraints jeopardise equitable health outcomes for rural families.

Chair of Hauora Taiwhenua, Dr Fiona Bolden, comments that “the survey results show that those living rurally are getting less and less likely to receive the equitable health care that was promised under the Pae Ora Healthy Futures legislation, and the pledges of the coalition Government. This means that those living in rural areas, and those visiting rural locations on holiday, can no longer be assured of timely access to medical care. 39% of practices aren’t open to new enrolments and 24% of practices offer no hands-on after-hours care. Telehealth, even if you can access it in a remote rural area, is no answer to a bleeding wound or major medical event. The postcode lottery of health care is getting worse for rural communities – and that is simply unacceptable!”

The insights from this year’s survey shed light on the challenges facing those delivering health care rurally. Despite can-do innovations by rural general practice, such as multi-disciplinary health teams that have evolved to meet local needs, this is not enough. Those teams are under strain, with GPs bearing additional responsibilities for clinical supervision and facility maintenance. This strain limits practices’ abilities to accommodate visiting specialists and train future rural health professionals, placing further pressure on rural health infrastructure.

The health of rural communities needs immediate and targeted attention, which can only come through strong support for their struggling general practice teams.

© Scoop Media