While funding is undeniably a factor, and more is certainly needed, other crucial initiatives must be implemented to reduce waiting times, enhance productivity and staff satisfaction, and improve healthcare outcomes. Continuity of care, such as seeing the same doctor, is the most desirable outcome, but this model is unsustainable and therefore needs to evolve.
Martin Hefford, director of the national agency’s Living Well division, stated the system currently lacks around 200 GPs, with projections indicating this shortage could reach 1000 by 2033 due to an ageing population and rising healthcare demands. With 37% of GPs planning to retire within the next five years, this shortage could leave approximately 1.5 million New Zealanders without a primary care provider, highlighting the urgent need to rethink how we deliver primary care.
A key part of this rethinking involves better utilisation of our broader healthcare workforce. Nurses, nurse practitioners, pharmacists, and mental health workers are essential to easing the burden on GPs, enabling them to focus on the most important patient care where their skills are most needed. By expanding the roles of these professionals, we can ensure timely care without overloading GPs. Some GPs may argue that focusing on more complex patients will increase their workload.
However, this is only the case if they remain tied to the traditional model of 15-minute appointments, where the only way to cope is by using straightforward cases to offset the time and emotional burden of managing more complex ones. By reimagining primary care through a proactive, multidisciplinary, team-based approach with diverse ways of working, the GP’s specialised role wouldn’t become more difficult – it would become more effective, fulfilling, and rewarding.
GPs should have the opportunity to specialise in areas such as women’s health, minor surgeries, paediatrics, or chronic disease management, and actually have enough time to practise their specialisms. By honing their expertise, they can provide higher-quality care for complex cases, while other healthcare professionals manage more routine needs. This approach not only reduces the overall burden on GPs but also ensures patients receive the most appropriate care from the most qualified professionals.
In Australia, the expansion of GP roles has been successfully implemented in “Gold” and “Platinum” standard clinics. These clinics empower GPs to directly refer patients for advanced tests such as MRI scans, traditionally requiring specialist involvement. By integrating care teams that include nurse practitioners and allied health professionals, these clinics allow GPs to manage complex conditions more effectively within the primary care setting.
This model has improved patient access, continuity of care, and reduced unnecessary hospital admissions, demonstrating how an expanded GP scope can lead to a more efficient healthcare system. Adopting similar approaches could greatly benefit New Zealand by allowing GPs to play a more central role in managing complex health issues. We need to move towards a model where seeing different clinicians doesn’t compromise care, ensuring patients with the most complex needs are prioritised within the same care team.
Ensuring continuity of records, medication, communication, and relationships is vital. It is alarming that New Zealand lacks a universal digital health record, complicating every engagement within the health system due to the absence of robust and accurate data.
This simply shouldn’t be the case in the 21st century. To bring healthcare into the modern age, we must separate urgent care from proactive and preventative care. Our system is currently overwhelmed with routine issues such as coughs and colds, diverting attention from critical population health efforts such as immunisation and cancer screening.
Burrell highlighted that if just 6% of patients chose to go to emergency departments instead of their local doctor, ED presentations would double – putting immense strain on already overburdened emergency departments. This is a serious concern for all of us. When patients can’t access primary care and turn to the ED, it compromises the ability to deliver urgent, life-saving care in these critical settings. The introduction of AI, telehealth, and other innovative tools offers tremendous potential to make healthcare more efficient and effective.
However, small practices often struggle to implement these technologies on their own. To truly transform our healthcare system, we must invest in scalable solutions that reduce the reliance on GPs, integrate advanced technologies, and support the transition to new models of care. While the traditional family doctor/GP model is cherished, it is no longer sufficient for the future. As Burrell aptly noted, it’s “already dead”.
Embracing these changes isn’t just preferable; it’s crucial to building a resilient, equitable, and future-ready healthcare system.
