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Budget 2023: More investment desperately needed for overwhelmed primary healthcare sector

Despite some reprieve from Budget 2022 and a small boost to international recruitment, problems within the primary healthcare sector remain overwhelming, says Pam Newlove, partner and healthcare lead at Grant Thornton New Zealand.

Money allocated in Budget 2022 has just started to flow into the sector for funding based on how many high-needs patients are enrolled, and in April 2023, practice nurses and doctors were among 32 health sector roles added to the Straight to Residency immigration pathway. It followed a new immigration pathway that was quietly launched in December 2022, and funding for a training scheme for nurse practitioners. And in October 2022, it was announced that first-year GPs would get pay rises, and specialist GPs would receive more funding to train GPs and host junior doctors.

However, a mass exodus is now underway due to General Practitioners’ working conditions and as aging practitioners prepare to retire. Newlove also points to damning evidence in the 2022 Workforce Survey by the Royal New Zealand College of General Practitioners:

·     25% of respondents were aged 62 or over, and 55% of respondents said they planned to retire by 2032

·     79% said they were experiencing burnout, with nearly half (48%) rating their burnout level as ‘high’

·     A third (31%) said they would not recommend general practice as a career

·     20% of work was unpaid time

And, according to the 2021 GP Future Workforce Requirement Report, there will be a shortfall of 300 GPs by 2031. 

“The cascade of negative outcomes has no upside. Patients often end up at our public hospitals or A&E departments because they need medical care they can’t access at their local GP, and this exacerbates the pressure our hospitals are already experiencing which ultimately leads to increased unnecessary costs for our economy.

“In the worst-case scenarios, patients who can’t see a doctor may put off seeking care for too long, and then require expensive treatments for more severe illnesses – or die prematurely,” says Newlove.

Some quick wins in this year’s Budget could help ease the pressure

Train more doctors

At a national level, the Future Workforce report estimated that training 100 extra GPs each year would significantly benefit the New Zealand economy. The report calculated it would produce a net gain of between $338 million and $800 million. 

Newlove says, “And more importantly, this would reduce the patient demand on each individual practitioner. That would hopefully translate into shorter waiting times for patients, lower rates of burnout for doctors, and less stress for everyone working at a practice. It would also provide succession options for older practitioners who would like to retire”.

Show junior doctors the advantages of general practice

“Junior doctors need to spend time in a general practice setting to see the advantages before ruling it out as a career option. It has a degree of flexibility, community and sociability, but many junior doctors are dismissing it without full consideration.  

“I believe increasing post graduate time in general practice to six months or more, up from the current 13 weeks, would help recruit more GPs.

“For this to work, funding must also increase for the practices that host and train the juniors. Under the new funding, each placement of a PGY1 or PGY2 doctor on a 13-week community-based attachment, a practice will receive $3,600. But that equates to $200 a week, or $40 per day; simply not a suitable rate of recompense in a developed economy. General practice owners will tell you this does not go nearly far enough to cover the real costs of lost revenue,” says Newlove.

Recruit more international doctors and nurses – and incentivise rural practice

Newlove says, “The recent changes introduced to recruit more doctors from overseas needs to keep gaining momentum. We also need to focus on recruiting doctors in rural areas and incentivising them to stay so they don’t springboard directly into better paid roles in Australia. That type of incentive will also need to apply to local graduates, particularly because the problem of impending retirement is most acute in the provinces”.

For more information, read Pam Newlove’s full article here.

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