There's 100 things to do

“There’s one hundred things to do.” That’s what Minister Verrall said during our first official meeting with her, on the day that coincided with the release of our 2022 Workforce Survey results.

The results of the survey made for grim reading and many of the findings had increased since the previous survey was carried out in 2020.

We shared this with the Minister, and she understood our concerns and our frustrations. After all, this isn’t new intel. We shared the findings that were of most concern to highlight the urgent need for action if there is the expectation that specialist GPs and rural hospital doctors are to continue being the first point of contact for 90 percent of New Zealand’s healthcare needs.

We told her that:

• If all the over 65-year-old specialist GPs retired tomorrow, there would be another 725,000 patients without a doctor
• 78 percent of respondents said they were experiencing some level of burnout, with 48 percent rating themselves as ‘high’ on the burnout scale (up from 31 percent in the 2020 survey)
• Nearly one third of GPs would not recommend general practice as a career
• 20 percent of our work time is unpaid time
• Fellowship as a qualification attracts no change in remuneration
• 64 percent of respondents intend to retire by 2032

With the biggest response rate of any survey to date, completed by 70 percent of the membership (3,488 respondents), this survey has given us a clear and very realistic big picture of the precarious position that specialist general practitioners and rural hospital doctors are in.

Three of the 100 things have already been implemented, with last year’s announcement of more funding going into GP training – pay parity for registrars, four hours of teaching time for our teachers and funding towards hosting a PGY1/2 in the community-based attachment. This will help and is a step in the right direction, but it is only the tip of the iceberg.

With Budget Day next month and the election campaigning about to begin, we must grab the opportunities that this presents and put into effect the actions that will make a difference to the 4.9 million New Zealanders who are enrolled with a general practice.

I attended the webinar upon the release of the findings from the Immunisation Taskforce. This itemised 54 recommendations, many of which had started already. There was also no prioritisation as all of them needed to be done. Oh, how I wish we could do the same for the GP team in the community.

Minister Verrall and I discussed many of the 97 other actions - some are yet to be described, but some are already underway.

Training more medical students and ensuring they can do some of their training rurally or in the community they came from. Talks are happening with the Universities and those who fund medical training. There is also a proposal presented jointly by Hauora Taiwhenua, the College, University to Auckland and University of Otago that is being considered.

Promoting general practice within the hospitals and getting serious about PGY1/2 placements in general practice is also a key component. We suggested six- or 12-month placements. We know discussions are underway with the Medical Council to ensure current community-based attachments are happening in general practices.

Advertising what general practice is about to newly graduated medical students must continue. We offered collateral that we’ve created to support discussions and help with overseas recruitment.

We discussed the lack of recognition of GP Fellowship and how every other qualification confers some benefit in remuneration - whatever the qualification is - except for GP training.

What we need is the government to recognise that any investment in community medical care is the right thing to do. No one can criticise actions that improve health care to the community.

Thank you to the 3,488 of you who took the time to complete the survey for us, which was likely to have been done outside of your normal working hours and while a mountain of paperwork awaited your attention.

We will use this information to advocate for change and to also highlight the positives about the role to encourage more doctors to join us.

Column published in NZ Doctor 26 April 2023