New Zealand is at a crossroads in our health system.
We have been well served in the past by our primary care (general practitioners and other services) and secondary care (hospital services).
However, many challenges are occurring which threaten the current system.
We have overloaded hospital emergency departments and a large cohort of GPs retiring with fewer young doctors to replace them.
There are tsunamis of obesity and diabetes, which threaten to overwhelm our health service.
We have an aging population, with increased need for cancer treatment, joint replacements, and aged care services. What should we do?
Put simply, there needs to be a radical shift to screening and preventative medicine.
The current system depends largely on the patient accessing the service when they feel unwell.
Many people are not registered with a general practice, or don't attend, and not everyone realises when they need to attend.
Young people in particular don't necessarily build up a relationship with their doctor or don't always feel comfortable going to a GP.
In other countries including China and Slovakia, the government funds a full medical check and investigations yearly for all its citizens. Problems are identified early.
I am a former GP currently working as a Panel physician doing immigration medicals for visa renewals.
We take a patient's history, do a full examination and screen for hypertension, diabetes, anaemia, hepatitis B and C, HIV, and many other illnesses.
We discover many problems that the clients are unaware of. Why couldn't New Zealand do the same thing for our general population?
These health checks could be done in general practice or in screening hubs - which could also do vaccinations, cervical, breast, prostate and mental health screening, and referral to other services when problems are identified.
Think of it as a WOF for your body. An overall health review can offer the patient a fresh perspective.
The pandemic has shown us that people will go to a screening hub for testing - especially if it is free and easily available. We need more of this. Public health has been underfunded for long enough.
School nurses could do similar yearly screening of children at school - and identify overweight or obese children, vaccinate children who are behind and identify problems which need referral.
Carrying on in the same way really is not an option. Wellness and prevention are the way forward.
- Dr Kerry Lamb is a former general practitioner who is a Panel physician involved in medical examinations for immigration visas.