Rotorua GP’s workload has her working 6-12 hours on evenings, weekends

Three Lakes Clinic GP Dr Cate Mills. Photo / Andrew Warner

A Rotorua GP who works between six and 12 hours on her evenings and weekends says workload demands are taking a “huge toll” on her and is considering how long she can continue.

Dr Cate Mills, who also spends up to five hours per week on medical education outside of business hours, says doctors may need the flexibility to “determine their own time” and ensure it was “recognised and adequately compensated”.

Meanwhile, another Bay of Plenty GP says having “dedicated and remunerated time” for patient follow-up and administrative work during the day was “not an unreasonable expectation to have”.

Health NZ Te Whatu Ora has acknowledged the pressures on the GP workforce and says it has taken “some steps” to improve the way it funds general practice.

GP working ‘every weekend’ to keep up with workload

Mills, who co-owns the Three Lakes Clinic, said she worked “every weekend” and some weeknights to do non-clinical work - between six and 12 hours per week.

Mills works 24 hours per week at the Three Lakes Clinic. She also works at the Rotovegas Youth Health Clinic and Fergusson Home and Retirement Village, and provides care for sexual assault victims.

Her weeknights were also taken up with education and peer review - “all the things that we need to do to maintain our competency and our registration”.

Three Lakes Clinic GP Dr Cate Mills. Photo / Andrew Warner

For example, Mills attended a “compulsory” seminar on the evening of March 7.

“This seminar took three or four hours to do to allow me to do one thing in general practice ... to be able to order an MRI scan for someone that had had an accident.”

The GP of 27 years said it was an “enormous amount of time” to do “one tiny fragment of something that I might do ... maybe two or three times a year”.

“It was quite a challenge for me because I had a child who was really unwell [on March 7] and so I’m trying to juggle being able to look after my own family and maintain my career and ability to do my job.

“It really is a huge toll.”

Asked how sustainable her workload was, Mills said: “It’s certainly a factor in thinking about how long I’m going to work for.”

She said the New Zealand population was relying on an “aged workforce” with GPs who were “about to retire”.

“And certainly, people [who] may retire earlier than anticipated because of workload.”

Having paid time for non-clinical work ‘not an unreasonable expectation’

In a press release, Royal New Zealand College of General Practitioners medical director and Tauranga GP Dr Luke Bradford said four and a half hours of patient consultations generated three and a half hours of follow-up work and helped to explain why getting an appointment could be difficult.

“To make ourselves available to see more patients, many choose to move the non-contact clinical work into our evenings or weekends, or sacrifice training, teaching or clinical governance time to complete it.

Tauranga GP and Royal New Zealand College of General Practitioners medical director Dr Luke Bradford. Photo / Mead Norton

“This is the work that we are not remunerated for, despite it being a core part of our role.

“Having dedicated and remunerated time to do important patient follow-up and administrative work during the day is not an unreasonable expectation to have. Neither is working more manageable hours and having a sustainable patient load.”

GP funding system ‘has limitations’ - Te Whatu Ora

Approached for comment, Te Whatu Ora Health NZ referred to a statement provided to the Bay of Plenty Times on March 7.

In the statement, Te Whatu Ora living well director Martin Hefford said it recognised general practice was the “cornerstone” of the health system, providing vital care to patients.

“We acknowledge that the current capitation funding system for general practice has limitations, as it does not include important factors such as socioeconomic status or ethnicity.”

Hefford said Health NZ acknowledged the pressures on the GP workforce and was addressing this through targeted international recruitment and domestic training.

He said Health NZ had taken “some steps” to improve the way it funded general practice capability and capacity.

Funding for all primary and community health services, including general practice, increased by 5 per cent from July 1 last year, he said.

Hefford said an equity adjustment to capitation had been implemented to lift funding for Māori- and Pacific-owned general practices, and those general practices with an enrolled population of at least 50 per cent Māori and/or Pacific, by a total of $24.4 million in 2023/24.

He said Health NZ was also adding more GP and nurse practitioner training placements and supported introducing new workforces into primary care through initiatives such as the comprehensive primary and community care teams.

Megan Wilson is a health and general news reporter for the Bay of Plenty Times and Rotorua Daily Post. She has been a journalist since 2021.