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Patients will continue to face long wait times unless the Government looks at changing the 15-minute consult, some GPs say.
The Government recently announced changes to the health system to tackle wait times – including an extra 100 placements for overseas-traineddoctors to work in primary care.
But some GPs told RNZ’s First Up a key part of the problem was the 15-minute appointment, which was not long enough to complete a consult and do all the administrative work involved.
Patients face long wait times due to inadequate 15-minute consultations and administrative burdens, say GPs.
Data from Stats NZ shows one in four Kiwis do not visit the GP because it takes too long to get an appointment.
Dr Karl Cole works as a GP at Papatoetoe Family Doctors in Auckland. On a typical day he sees up to 30 patients and has hundreds of messages in his inbox.
After each 15-minute appointment, Cole is expected to fill in multiple forms.
“There’s all these hoops to jump through,” he said.
“Each form is done in different technology, done with different ways of authenticating. You basically need to do a degree in understanding which process [is] needed for which situation.”
These forms were not easy to access. He said demand has skyrocketed over the past few years.
“There’s been like a fivefold increase in inbox messages coming in. Six years ago I got 30,000 messages a year, and just on another order, it’s 150,000 this year.”
It ‘can be a terrifying 15 minutes’
Cole said most GPs would be doing several hours each day to catch up on the admin.
When seeing a new patient, he said 15 minutes was not enough to study their history, discuss symptoms and fill in paperwork.
“The 15 minutes can be a terrifying 15 minutes when it’s a new patient who might be 70, who’s got 16 medications, who’s got a new kind of symptom. You just can’t do it.”
Dr Sam King also worked at Papatoetoe Health Hub. She also said sometimes patients needed longer appointments, especially where there were language barriers and multiple health issues.
“For some patients, 15 [minutes] is not enough and you’re talking about multi issues and difficult histories, people with poor health, literacy, people with English as a second language - all of those things mean it’s very difficult.”
That – combined with the admin work – meant regular patients faced long waits for a routine visit. By the time people got to see their GP, they had a laundry list of symptoms.
“Part of the issue is that because people can’t get appointments when they want, when they come, they have a list. And it’s that we really struggle with,” King said. “I think if you definitely, if you increase funding then we can stretch out the 15-minute appointments.”
In July, the Government increased general practice capitation funding by 4%. That was despite warnings from the primary care sector that a double-digit increase was needed.
From July this year, the Government was adding a $285 million boost, delivered over three years. But that funding is performance-based.
In a statement, Health Minister Simeon Brown said it gave GPs flexibility when it comes to the 15-minute consult.
“This funding is in addition to the capitation funding increase that general practice receives annually to account for population changes.
“One of the advantages of capitation is that it gives GPs flexibility about how they meet the needs of their patients – they are not tied to delivering 15-minute appointments. They also have flexibility in the workforce they use.”
The Government was also adding 100 placements for overseas-trained doctors to work in primary care.
Dr Birgit Holzinger trained and practised in Europe for 10 years before moving here in 2023. She now practised in Tauranga, and believed New Zealand needed to focus more on preventive care.
“I think the biggest problem, at least the one that I can see from my perspective, is basically funding and I just feel like that’s a little overlooked here in New Zealand and it’s more acute care, but not really preventive care, which we should be focusing on a lot more.”
The Government also announced a 24/7 telehealth service – which means patients needing urgent care can access video consults with GPs and nurse practitioners. But King said that could compound the problems they faced.
“A lot of GPs are wanting to move to the telehealth services simply because it’s easier, it’s faster. You deal with the minor issues, which means that all the complex patients and usually their elderly end up in front of the GP and they are never the 15-minute consultation.
“So you’re compounding the problem by just pushing more doctors into the telehealth realm, and I think it’s a little short-sighted.”
A study published by the Royal New Zealand College of General Practitioners in March looked at primary healthcare funding data from 2009 to 2023. It highlighted the need for greater financial prioritisation of primary healthcare in New Zealand.
The report recommended routine monitoring of primary healthcare funding as a proportion of the total health budget and establishing a minimum allocation.
