A shortage of GPs is leaving some in Whanganui unable to enrol at a doctor's practice, with the challenge of recruiting GPs also causing concern.
Whanganui Regional Health Network (WRHN) chairwoman Judith MacDonald said the "unfortunate reality" was that a growing population meant doctors in the district were being put under strain.
"Post-Covid, I did quite extensive community consultation to understand what's going on, and clearly we have an issue where we are getting to capacity in the city," MacDonald said.
"Where, maybe 10 years ago, private general practices would say they'll expand with demand, as people get a bit older they're careful about expanding their practice if they don't feel they can cope with that quantum of people."
MacDonald said with GPs under pressure, the result was more people turning to alternatives such as the WRHN-operated Whanganui Accident and Medical Clinic (WAM).
"I am aware that our waiting times are longer, and I'm aware that WAM are seeing a volume of non-urgent care, which indicates a mismatch between receiving a primary healthcare appointment and seeking alternative care.
"The fact is, our population has grown and our infrastructure hasn't, just like our roads haven't. It's a funnel - there's a demand issue."
The Chronicle was this week shown a letter from a Whanganui general practice, saying that they were operating at "full capacity".
In the letter, the practice told a prospective patient they must first pay $60 to undertake an "initial consultation".
After that appointment, the practice would decide whether or not to enrol the patient, based on their health needs.
"Our priority is that everybody receives fair, timely and good health care. We want all your needs to be met. This may mean we decline to enrol you if we feel necessary," the letter read.
The letter said that there would be no charge if an application to enrol was declined.
The surgery didn't respond to the Chronicle's request for comment, but MacDonald said while she respected the independence of private businesses, the approach didn't sit terribly comfortably with her.
"It would not be the sort of policy that we would operate in our practices, put it that way."
Wheturangi Walsh-Tapiata, Mātaiwhetū/chief executive at iwi health provider Te Oranganui, said their designated facility, Te Waipuna, often had wait times of up to two weeks for non-urgent appointments - the result of increasing demand.
The organisation was currently advertising two GP vacancies - both of which Walsh-Tapiata said had been advertised for some time.
"We've got vacancies that have been sitting there for a period of time and they're still not filled. For example, not now but around a year ago, we had to close our books. Our books aren't closed at the moment, but they're limited in our ability to take on other patients.
"For all of the time I've been with this organisation, we've always had gaps in terms of recruiting general practitioners and it also means we've had a pivot of thinking to consider nurse-led clinics.
"If we could find a few more GPs, we'd love it."
Age Concern Whanganui manager Michelle Malcolm said the organisation had fielded queries in the past about the length of time some patients were waiting for doctors' appointments - some up to two weeks.
"It hasn't been overly prevalent recently, but we've received calls from people saying that in some cases, they're being told there's up to a two-week wait for an appointment at their GP," Malcolm said.
"If you're of a certain age and need to visit the doctor, there's usually no two ways about it. The wait times are a concern for some people who have got in touch with us."
Rangitīkei MP Ian McKelvie said the issue was even more challenging in rural areas around his electorate, where there were few practical alternatives to GP care, such as emergency doctors.
McKelvie said it was not unusual for people to come into his electorate office raising concerns, not only about wait times for GP appointments but also enrolling with a practice in the first place.
"We get quite a lot of people through our offices raising the lack of GPs, particularly around Whanganui and Raetihi. Marton is also desperately short.
"Not only can't we keep foreign doctors here because of immigration settings, we can't get them in here either. So it's very challenging."
McKelvie said in some instances, new residents who had recently settled in the electorate were still enrolled with their doctor in their previous place of residence because they couldn't access a GP locally.
"It's mainly people that move and can't get a doctor. Some of these doctors have upwards of 1200 people and it's pretty testing for them."
"If someone shifts here from Tauranga for example, they've got to go back to Tauranga for the GP. We've seen cases like that, and it's just ridiculous."
Whanganui MP Steph Lewis was contacted for comment.