Health Minister Andrew Little wants those involved in the GP/Mahitahi Haoura stoush to fix it now.
On Wednesday, the Northern Advocate revealed the near-complete relationship breakdown between some general practice doctors and managing primary health entity, Mahitahi Haoura, over a health reform proposal sent to Little in December.
The proposal, sent by the Te Tai Tokerau Māori Health Providers Alliance and supported by Mahitahi, suggested creating a $300 million Oranga Māori Entity (OME) to coordinate all Northland primary healthcare outside hospital care.
Given GPs administer most primary care, some were angry they were not consulted on the proposal. It was the last straw for GPs who had no trusting relationship with Mahitahi and were considering leaving it.
Little said it was imperative the relationship be mended to achieve effectual reform.
"GPs need and deserve a lot more support than they've had typically, and it's disappointing that they've been put in the position they have been," he said yesterday.
"I think what [the alliance] is proposing could make a huge difference, but in the end it's not going to make a difference if a whole bunch of GPs decide they're not going to be part of it."
The alliance's proposal was centred around achieving wellbeing, with Māori health providers and iwi coordinating primary health and social service provision. GPs maintained they were open to discussing the proposal.
Little said he favoured the inclusion of health and social services, but wouldn't be drawn on what he considered unfavourable.
Proposals had been sent to the Government's transition team, which was charged with executing wide-ranging health reform recommended by last year's Health and Disability System Review.
Little estimated decisions on reform would be publicly announced before May, with a potential rollout within a couple of years.
The Northland District Health Board had also sent a proposal that focused on a whānau-centred approach. It did not support the alliance's proposal in how the OME would manage all primary care, but did support it with reference to Māori health.
Read more: Northland DHB proposes whānau-centred fix
The national review recommended a drastic reduction in DHBs, from 20 to as low as eight. Northland's DHB could be absorbed into a northern region body with Auckland's three DHBs.
Although he acknowledged Northland healthcare based in Auckland was unsustainable, Little said serious questions needed to be asked of the NDHB over the region's sobering inequity statistics.
"The fact that there's the issues of access to healthcare and inequitable health outcomes for the Northland population, and especially the Māori population, that's a question the NDHB's going to have to answer: what have you done to address those issues in the 20 years you've been in existence?"
NDHB chief executive Dr Nick Chamberlain declined to comment.
Little believed inequity had exposed tensions in Northland's healthcare system and collaborative and inclusive mahi from stakeholders was needed to fix it.
However, Little said any reform would prioritise tino rangatiratanga and equity.
"If I've done my job right then in five years or maybe a little longer, people can turn up to a clinic not too far distant from where they live, and they might see a GP, they might see a nurse practitioner.
"They can talk about their issues and [the GP] can work out whether it's a medical issue or one that requires other services, and plug that person into the right support that they need, especially for Māori."
On Tuesday, a large proportion of Northland GPs met to discuss whether to leave Mahitahi and form their own body. There was consensus about conflict with the primary health entity, but further kōrero was required to confirm next steps.
Mahitahi chief executive Phillip Balmer wouldn't comment on whether he was confident no GPs would leave, but said he was committed to hearing their concerns.
Balmer said consultation meetings for all GPs and Māori health providers would be held next week in Whangārei, Kaikohe and Kaitaia.