The Northland DHB, PHO and providers are working on a solution to Kaitaia's shortage of GPs (GP crisis bites Kaitaia, May 9), but DHB chief executive, Dr Nick Chamberlain, said the situation was the inevitable consequence of challenges in recruiting and retaining a general practice workforce that all rural health care services were experiencing.

"This is a common issue across all of rural New Zealand," he said.

The provision of primary care services was the responsibility of PHOs, but the DHB had good relationships with that organisation and general practices in Kaitaia. It could assist in providing a solution, and would continue to work collaboratively to ensure access to services.

Dr Chamberlain said the problem in Kaitaia was compounded by visitors to the area stretching GPs' resources to unsustainable levels.

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"This means more and more patients are being seen at after hours services later in the evening, which is unsustainable. This is why the practices have closed their books," he said.

The DHB was now moving to take responsibility for overnight services from the general practices, the same model that had been implemented in the Kaipara and Mid North, to enable primary care doctors to focus on managing the wellness of their "population" during the day. That would also make the Far North a more attractive place for doctors to work.

"The DHB understands that patients who are enrolled in a general practice in the Far North should still be able to access their own doctors and nurses," he added.

The DHB would provide an urgent service for unenrolled patients who could not be seen by one of the general practices, but would be required to make a "co-payment". Meanwhile the DHB would continue to work urgently with the PHO and practices to explore solutions to ensure that patients would be able to enrol with a general practice as soon as possible.

"Longer-term we are hopeful that practices will be able to recruit more GPs to the region, but they may also need to consider the option of alternative workforce roles such as nurse practitioners," he said.