Rural general practice teams are the backbone of the health system for their communities, providing essential and preventive care to patients. However, they are under-resourced, over-stretched and under-staffed. Chair of Hauora Taiwhenua Rural Health Network, Dr Fiona Bolden, says that “our recent survey of rural practices showed that the situation is truly dire.”

• 60% of rural practices are advertising for one or more doctors. Some have been unsuccessful in recruiting replacements after advertising for more than two years.
• Reports are that New Zealand has lost over 5000 nurses to Australia in the past year.
• The majority of rural practices are reporting low morale and unsustainable finances.
• Rural practices are closing, and others are reducing services leaving few options for rural communities.
• The New Zealand Health Survey published last week revealed that approximately one million people in New Zealand reported that it was taking too long to access timely and affordable primary care. The survey showed that adults reporting issues with getting a timely GP appointment had almost doubled over the past year from 11.6% to 21.2%, and that cost is the biggest barrier for adults to visit a GP.
• The only other option for rural people is a long trip to already over-crowded A&E departments in urban hospitals. Many just don’t bother or can’t fund the trip.

Dr Bolden believes that the situation is capable of being saved and built on to provide a strong and accessible health system for our rural communities, but it needs immediate investment and support as was promised in pre-election promises by both National and ACT health spokespeople. Investing in primary care is the best way to improve health outcomes and reduce health inequities for all New Zealanders. Timely access to general practice reduces late presentations, reduces emergency department attendances, and saves money for the health system.

Dr Bolden states that “the long-term solution is to train more doctors, nurses, and other health professionals here in New Zealand; and the strong evidence points to the fact that for rural communities, that training is best done for rural students, trained in rural areas, by rural health professionals. The whole system risks collapse if there are no rural health professionals left to train others because they are burnt out, retired, or been lured overseas by more money and better conditions.”

Hauora Taiwhenua urges the coalition government to implement the recommendations of the recent Sapere report into General Practice funding, which recognises that base funding needs to reflect rurality, comorbidity, deprivation, and high-need populations. The report also proposes a renewed model of funding that would enable general practices to provide more comprehensive and integrated care for their communities, keeping them from hospital admissions and the associated costs in many instances.

Hauora Taiwhenua calls on the government to urgently fund rural general practice to appropriate levels in order to meet the needs of those currently missing out and those who will miss out when practices fail. The problem is getting worse by the day as immigration increases and health professionals head out of the country. All we want, and what New Zealand needs for Christmas, is the promise of investment to keep our rural family clinics open and functioning.

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