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Home / New Zealand

Northland doctors say general practices on life support

Denise Piper
By Denise Piper
Multimedia Journalist·Northern Advocate·
27 Dec, 2023 04:00 PM4 mins to read

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Dr Geoff Cunningham of Bush Road Medical Centre says GPs in Northland are now "terminal", due to a broken funding system. Photo / NZME

Dr Geoff Cunningham of Bush Road Medical Centre says GPs in Northland are now "terminal", due to a broken funding system. Photo / NZME

Northland’s general practices are beyond crisis point due to a lack of Government funding, high-needs population and other doctors retiring or quitting, GPs say.

The issues have been acknowledged by Health Minister and Whangārei MP Dr Shane Reti, who is looking into the matter with urgency.

The comments after a national survey shows the long time to get an appointment is the biggest barrier to patients visiting a GP.

The NZ Health Survey, released last week, said 21 per cent of Kiwi adults did not visit their GP in the last year because of the long time to get an appointment, almost double the 12 per cent last year.

Cost was the next biggest barrier, stopping 13 per cent of respondents from visiting their GP, while inability to get time off work impacted 7.4 per cent.

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The barriers are likely to be a lot higher in Northland, where about 25,000 patients cannot enrol with a local general practice due to a doctor shortage.

Bush Road Medical Centre director and GP Dr Geoff Cunningham said the situation for Northland general practices is dire and likely to get worse.

“It’s terminal, it’s past the tipping point,” said Cunningham, who has long signalled a looming crisis.

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The money from central government - called capitation funding - has been underfunded in Northland for more than 20 years and has never caught up with the rest of the country, he said.

This, coupled with restrictions around what patients can be charged, means a number of Northland practices are insolvent and may be forced to closed their doors.

“It’s an absolute crisis and we can’t attract GPs up here because we can’t pay them.”

A review into GP funding in 2022 by Sapere found high-need practices need a funding increase of 34 per cent to 231 per cent, but many Northland practices would need up to 300 per cent now, Cunningham said.

Health Minister Dr Shane Reti agrees there are problems with the funding of primary care and he is urgently looking at solutions. Photo / Michael Craig
Health Minister Dr Shane Reti agrees there are problems with the funding of primary care and he is urgently looking at solutions. Photo / Michael Craig

Northland is not only underfunded, its population is older, has a higher Māori population and has greater deprivation, requiring more care, he explained.

“It’s really high-needs. It’s a very difficult population to look after.”

Dr Andrew Miller, also from Bush Road Medical Centre, said the situation is so bad in Northland the numbers of patients without a GP could balloon from 25,000 to 100,000 if a solution is not found urgently.

“There is a tsunami of trouble about to arrive.”

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Funding general practice not only saves costs to the health sector down the line, patients extend their life if they have a good relationship with their GP, he said.

Miller believed there was a way forward, including funding models to help GPs be more efficient, and he was hopeful Reti would come to the party.

“If a Northland Māori GP is not able or willing to sort this out, then who would?”

Funding should go to practices working with high-needs patients, Shane Reti says

Reti acknowledged the issues in the primary sector - including funding and access - and said he was looking into it with urgency.

“I acknowledge there are some significant issues impacting on primary care across the whole of New Zealand, particularly the ageing workforce,” he said.

“And, given New Zealanders receive most of their healthcare from the primary care sector, it’s important these are addressed with some urgency.”

Reti met with General Practice Leaders Forum chairwoman Dr Samantha Murton on his first day as Health Minister and is expecting official advice on ways to implement recommendations from the 2022 Sapere Review.

“The principle that I’m looking to have reflected is that where the work is done, that’s where the funding should go – particularly those practices with high needs and a high morbidity focus.”

Reti is also focused on developing homegrown, culturally competent doctors, he said.

Denise Piper is a news reporter for the Northern Advocate, focusing on health and business. She has more than 20 years in journalism and is passionate about covering stories that make a difference.

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