Budget 2025: We don’t need to create a different health service, we need to invest in the current one - Dr Samantha Murton & Dr Luke Bradford

Primary care investment is considered crucial for the New Zealand health system's future. Photo / 123rf

THREE KEY FACTS

• The health system faces stretched workforces, long wait times and closed books.
• Investing in primary care offers potential savings of $14 for every $1 spent.
• Aligning primary care funding with OECD countries could enhance services and reduce hospital admissions.

Our health system is ready for a new chapter. Across the sector we are seeing workforces stretched to capacity, long wait times and closed books.

As health professionals it hurts to see patients not getting the care they need, when they need it. To fix this, we need solutions that are cost-effective, sustainable, fair and patient-focused.

We don’t need to create a different service. We need to invest in the current service and recognise the opportunity that lies within general practice for communities to thrive and be healthy.

We know healthcare starts and often ends in the community. We have 23 million patient contacts each year, far more than any other medical specialty.

Our clinics are innovative, offering rapidly evolving services and options for access through a broad range of expert professions.

Investing in primary care is the most cost-effective way to address the challenges in the sector. Primary care teams across many other OECD countries receive, on average, about 14% of their overall health budgets (based on 2016 data).

In New Zealand, however, primary care receives on average less than 6% of the health budget. If we can provide 23 million patient contacts per year on less than 6% funding from the health budget imagine what we could do if we had fair and fit-for-purpose funding.

Imagine if we were in line with other OECD countries and primary care was funded for the work we do and the increasing patient need we’re seeing.

OECD countries allocate 14% of health budgets to primary care (2016). Photo / 123rf

Evidence shows if you have the same GP for more than 15 years your mortality is reduced by 25%, hospital admissions are reduced by 28% and out of hours visits are reduced by 30%.

For every $1 spent in primary care, $14 is saved further down the line in secondary or hospital-based care. Our continuity of care enables us to pick up issues faster and ensure patients get the care they need. So how can we achieve this?

Improving the appeal of general practice careers

We can do this by:

• Having a fully funded three-year training programme for all GP trainees. Currently GP trainees have to pay for their own training after the first year.  
• Increased exposure to general practice (in urban and rural communities) throughout medical school and postgraduate years 
• Developing rural specific training to support those who want to work rurally 
• Remunerating the workforce for all the work that we do, not just the patient-facing time.

Recognise GPs who train the future generations

Increased funding in primary care has the potential to save the broader health system money. Photo / 123rf

We want GPs to be recognised for their commitment to training so they can help grow all parts of the general practice workforce.

Rectify the pay gap between primary and secondary care nurses

Primary care receives less than 6% of New Zealand's health budget. Photo / 123rf

We want to grow and develop nurses in primary care to provide more services and undertake ongoing professional development.

We have seen incremental change, such as the funding for urgent and after-hours care, which is a step in the right direction.

What we need now are targeted decisions and swift actions that set the workforce up to be sustainable and future-focused.

The health system faces stretched workforces and long wait times. Photo / NZME

Investing in general practice will have positive impacts on the communities we serve, the health and wellbeing we support and the people we care for.

Doing so saves the broader health system money and is a positive investment for the taxpayer.