$285 Million GP Funding Boost A Good Start, But More Information Needed

Health Minister Simeon Brown announced this week that Health New Zealand would provide a $285 million “uplift for general practice over three years”.

General Practitioners Aotearoa (GPA) is very happy to see the new Minister focusing his attention on general practice, and welcomes the funding.

“We are excited about this announcement, and are waiting with bated breath to find out if the funding will end up on the front line where it is desperately needed,” says GPA chair Dr Buzz Burrell.

Brown also announced incentives for primary care to recruit up to 400 graduate registered nurses per year for three years, 100 clinical placements for overseas-trained doctors, and a new 24/7 digital health service providing video consultations to patients.

The announcement raises some questions. GPA would like more information, and has two recommendations.

More information needed

“There are some gaps in the Minister’s announcement,” Burrell says. “Firstly, we want to know if the cost of recruiting nurses, training foreign doctors, and the video consultation service comes out of the promised $285 million, or if it is additional.”

Brown’s announcement said $30 million had been allocated for the nurse recruitment initiative, without stating if that came out of the total $285 million.

“We also don’t know how comprehensive the proposed 24/7 digital service will be,” Burrell says. “What the staffing and technology will cost is anybody’s guess, but it’s got to be many millions of dollars.

“Once you take these things out, there isn’t much money left for getting more GPs and opening up appointment slots.”

Brown described the funding as a “performance-based uplift” that would incentivise GPs to do things such as:

• Keep their books open to new patients;
• Achieve government targets;
• Undertake minor planned care services; and
• See patients in a timely manner.

“This all sounds pretty reasonable at first glance,” Burrell says, “but we are deeply concerned that more responsibilities will be laid on GP plates when the current budget doesn’t stretch to cover what is already expected.”

If the conditions are in line with current expectations, then GPA considers that to be fair. However if there are new, more stringent requirements then GPs may be worse off under the new funding system.

It is unclear from the Minister’s statement how foreign GPs will be recruited.

“Simply making training positions available might appeal to a few doctors who are moving to New Zealand of their own volition, but I doubt they will fill 100 slots that way,” Burrell says. “We know that right now recruitment companies are having to charge practices around $50,000 to recruit a single foreign doctor and bring them to Aotearoa.

“Will the announced funding package be used for that?”

More information is also needed about how the money will be spent and distributed.

“We are really worried that little of this money will filter down to where it is really needed,” Burrell says. “If we want to make the situation better for patients, the Government needs to commit to improving working conditions for GPs, and we need to recruit more GPs.”

Funding for GP clinics is generally administered by primary healthcare organisations (PHOs).

“Some of our members have expressed concern that new funding will have the ticket clipped by Health New Zealand, PHOs and others along the way,” Burrell says. “We want some assurances that this uplift funding is actually earmarked and protected for the front line.”

Recommendations

The proposed digital health service has potential, but it needs to be carefully integrated with the current system.

“To be totally frank, digital health isn’t the ideal solution,” Burrell says. “But patients are desperate to get healthcare in the community, and there’s no quick way to fix the broken primary healthcare system so we’ll take whatever help we can get.

“Video consults were normalised over the Covid years, they are relatively cheap and accessible, and they make use of modern technology to see patients. That’s all good stuff.”

GPA recommends Health New Zealand implement a robust system with input from GPs, for supporting the video consultations.

“The main thing we need to know is that patients have somewhere to go in person,” Burrell says. “So when a doctor or nurse sees a patient over video and identifies a problem that needs to be dealt with, where will that patient go? Emergency department? Designated GP clinics? There needs to be a plan that doesn’t burden the current system.”

The provision to train foreign doctors is also a step in the right direction, because it helps address the fundamental issue that there are not enough GPs practicing in New Zealand.

However it is unclear if funding will go to help practices employ those doctors – and other GP trainees – once they complete their training.

GPA recommends that this programme be backed up by funding to help recruit more GPs.

“Otherwise there’s no incentive for practices to employ these foreign-trained doctors once they are qualified,” Burrell says. “There’s no point in training more GPs if nobody can afford to employ them in the current flawed system.

“Minister Brown’s announcement included a subsidy for recruiting nurses, but no such thing to help practices employ more doctors.”

GPA notes this is a three-year funding pledge.

“What happens in three years when it runs out?” Burrell asks.

The GP system needs permanent support to keep our patients happy and healthy.

“We are looking forward to working constructively with the Minister to get assurances that will make GP appointments and care more accessible for patients in the long run.”

About General Practitioners Aotearoa

General Practitioners Aotearoa (GPA) is the only independent organisation exclusively representing the voices of doctors working in general practice. We represent GPs who are clinic owners, employees, contractors and trainees. We are member-funded and receive no government money. GPA formed after the demise of the New Zealand Medical Association to independently advocate for GPs.

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