Amid a national health emergency, some general practitioners are now working for free, others have lost their jobs, and a small number of practices have closed because of the financial strain.

The primary care sector says it is desperate for more support from the Government or it is at risk of disappearing.

"The Government needs to move very urgently on this," said the medical director of the Royal New Zealand College of General Practitioners, Bryan Betty.

"Where we'll be in a couple of weeks time, I have no idea."

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The Government yesterday announced $30 million in initial funding support for primary care: $15m directed towards general practice and $15m for community pharmacies.

The initial funding is to cover the costs of patient separation infrastructure and equipment, virtual consult infrastructure and personal protection equipment (PPE).

The Ministry of Health said today it was doing "urgent work" around more funding for primary care to ensure practices were financially sustainable.

But the sector has already made tough decisions to try to weather the financial storm as its incomes dry up.

Yesterday, the board chair of Wellington Accident & Urgent Medical Centre wrote to its 180 rostered doctors that their pay would be cut by 20 per cent immediately.

Wellington Accident & Urgent Medical Centre has cut doctors' pay by 20 per cent. Photo / Mark Mitchell
Wellington Accident & Urgent Medical Centre has cut doctors' pay by 20 per cent. Photo / Mark Mitchell

In an email seen by the Herald, Sarah Sawrey said their monthly wages bill was very high and, even with the Government wage subsidy, the current situation was "completely unsustainable".

"I'm very sorry to be the bearer of bad news when things are already stressful enough and I hope you will understand the need to take drastic steps," she said in the letter.

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Sawrey told the Herald most of the centre's' funding came from patient payments and because everyone was isolating they just weren't getting the same numbers through the door.

As well, there weren't as many accidents or sports injuries which needed treatment.

And because after-hours clinics sat outside the Government's current funding offers, the board had to make the "very disappointing" decision to cut doctors' pay, she said.

"If we have a massive drop-off in numbers, we have a massive drop-off in income.

"It just wouldn't be sustainable long-term."

The pay cut would be reviewed when "the current situation improves".

A rural GP, who didn't want to be identified, has also taken drastic measures to manage the massive financial strain.

The practice's two partners have decided to not take any pay for the duration of the lockdown in order to keep their six full-time staff.

One of the doctors told the Herald the directive from the Ministry of Health to slash face-to-face consultations by at least 70 per cent late last month meant its income dried up overnight.

He completely agreed with and supported the move but said the Government needed to offer more financial support as the wage subsidy scheme wasn't enough.

"Our priority is our staff. We need them and can't work without them."

While he and his partner won't be paid until after the lockdown at least, they'd committed to pay staff their full salaries for the four weeks.

The subsidy scheme wouldn't cover two-thirds of their fortnightly staff bills, he said.

According to the Ministry of Health's announcement on the $30m primary sector funding, a general practice with about 5000 people registered would receive about $12,000 as an upfront payment.

A high-needs practice would get about $22,000.

The GP said he was also very concerned about the potentially huge influx of patients suffering from mental illness after the lockdown as a result of the isolation and anxiety around the economic impacts.

Hours reduced and healthcare staff cut

The Covid-19 pandemic was a national health emergency and yet the primary care sector was quickly sinking, Betty said.

"It's this incredibly odd situation that at a moment of medical crisis in this country, that this is actually happening."

Of the Royal New Zealand College of General Practitioners' 900 GPs, more than 600 had had their hours reduced and 60 had already been laid off.

The wage subsidy scheme the Government launched to help coronavirus-hit workers could cost as much as $12 billion.

Ninety-two locums were without work, and 142 doctors said they expected their hours to be reduced or lose their jobs.

Betty said the initial payment from the Government to cover the cost of transformation to virtual appointments and the wage subsidy scheme didn't cover their financial burdens.

Fewer patients in physical consults meant co-payments from patients were either not being collected or practitioners were waiting for patients to pay and, with non-urgent procedures stopped, there were no patient follow-ups.

And many patients could not pay as they had lost their jobs.

That meant many GPs were now seeing patients for free.

"Their loyalty is to their patients who want to come and see them and they want to keep their nurses and receptionists.

"And that's happening across the country."

Betty said the Government needed to move on the next stage in funding urgently to ensure the primary care sector was there on the other side of the Covid-19 lockdown.

He said they'd been told there would be an announcement next week about support for practices through this period, he said.

"They're going to have to do some kind of cash injection into the sector.

"They're going to have to essentially underpin the system with this loss of co-payment revenue over the next few weeks or however long this goes."

Delaying the flu vaccine deadline

Betty has also called on the Ministry of Health to delay the deadline for vaccinating high-risk patients from the flu to give it time to fix distribution issues.

Many practices in high-demand areas had ordered vaccines but received less than half, while other practices and pharmacies with fewer patients had excess supply.

In order to have time to solve this, the mid-April deadline needed to be pushed out until the end of the month, Betty said.

Bloomfield said today the Government was considering pushing it out, but its priority remained to have all high-risk people vaccinated by the middle of April.

Covid19.govt.nz: The Government's official Covid-19 advisory website