Dr Bryan Betty: Porirua GP on the government's funding boost for after-hours clinics

The government has announced $164 million in extra funding for after-hours doctors clinics around the country - but the announcement doesn't include any specific funding for services in central Wellington. 

Currently, those seeking 24/7 care are required to travel to a clinic in Kenepuru - and that looks set to remain the case. 

To discuss the announcement and the importance of after hours primary care, Porirua GP and chair of General Practice New Zealand Dr Bryan Betty joined Nick Mills.

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Episode Transcript

Speaker 1 (00:07):
You're listening to the Wellington Mornings podcast with Nick Mills
from News Talks.

Speaker 2 (00:12):
B our kind of resident GP guy that I always
like going to. He's not my GP, by the way,
but I would definitely love to go to him as
my GPS. Chair of General Practice New Zealand, Brian Betty
and GP and porty to good.

Speaker 3 (00:29):
Morning, Bright, Oh, good morning, nice to be here.

Speaker 2 (00:32):
Nice to talk to you. Now, I'm you probably get
the gist that I'm a little bit I'm a little
bit annoyed because I'm a and we've talked about it
before and it's not my idea, but it's an idea
I totally agree with. Get to your GP saves in
every way.

Speaker 3 (00:50):
Yep. Absolutely, Look, if you can't get your GP for
your ongoing medical needs, either a shoot or chronic, you
end up well, either it after hours or you end
up at an AD and putting pressure on hospitals. And
we know there's a really relationship. So call to the
system is a really well functioning general practice system that
you can access when you need to access. And that's

(01:12):
absolutely fundamentally here in terms of what happens.

Speaker 2 (01:15):
Now I understand and we've talked about it before, and
I understand your view is that the best person to
look after you is your own GP. Now I get that,
but you know what, if you've got an eight month
old baby or a twelve month old baby with an
asthma attack on Sunday night at eight o'clock, surely having
a twenty four hour, seven day a week GP system

(01:36):
like you've got Impotted or we used to have in
Wellington is the next best thing.

Speaker 3 (01:42):
I'll look access to after hours I think is very
very important. That plays a really important role across the country.
For the exact reason you've just just outlined that acute
illness doesn't happen between eight and five at night. It
occurs at any time, and there are often situations when
you do need to get vidical advice or get either

(02:04):
your child or yourself seen because something is actually occurring.
And again we know that if you can't do that,
you end up in an emergency department. So yeah, no, no, Look,
I agree with you. I think access to these after
our services is very important.

Speaker 2 (02:18):
Do you think it's as important as I do that
that twenty four hours, seven days a week for a
city like Wellington.

Speaker 3 (02:25):
Look, I think the Wellington situation is in the now.
We know we have twenty four hours in Kenneperu, so
that operates in Wellington. The service. The after our service
is open from eight in the morning to eleven at night,
so it is closed from eleven to eight. And the
reason that originally occurred was because it was not financially sustainable. However,

(02:47):
the Adelaide after Ours Medical Center is actually just down
the road from the emergency department and that is what
has actually done in that situation. The emergency department, which
which often isn't busy around that time, takes any overflow
that that's required at that time, so there is coverage.
It's not twenty four hours, but is from eight in

(03:08):
the morning to eleven at nine.

Speaker 2 (03:09):
Well can I can I just I mean, I'm getting
online and I've just checked and I believe it's till nine.

Speaker 1 (03:14):
Now, you know that's not their own website.

Speaker 2 (03:16):
Their own website.

Speaker 3 (03:17):
Says you're right, sorry, Nick, It has been cut back
to nine. Yes, yes, and again that's due to funding
and some funding issues and workforce issues. And part of
the government's announcement, because there's four separate parts to the announcement,
was to maintain existent edge and ours ours services because

(03:38):
there has been an initial around funding and how these
services are often funding and that that that is part
of what has been been sort of announced here. So
whether that addresses some of staying up to eleven versus nine,
it's really hard saying why.

Speaker 2 (03:53):
I mean, I'm asking you this because I know that
you're very well connected in your chair of the General
Practice in New Zealand, so you are in these in
the sanctums of meetings and talks. Why is it that
Wellington has not seen as important enough to put funding
in to have a twenty four hour, seven day a
week operation.

Speaker 3 (04:11):
Look, Look, I think it's for the reason that I
just explained. The way they've structured this is to say
you within an hour of a twenty four hour service,
and we do have Kennipury which operates in Porror Room,
which is twenty four hours. Then there is the daytime,
seven day a week service in Wellington and it's right
next to the emergency department down the road. And I
think that's what's happened. And I suspect the other thing

(04:33):
that's occurred here that there's some other areas of need
that's occurred. So if we look at the situation, Lower
Heart the after our center there actually opens later on
in the day, so it's only opening the evening, so
there's no emergency overflow system during the day, which is
why Lower Heart has been targeted to have an extended
daytime after our service. So that I suppose there was

(04:57):
a need that it started to emerge here in terms
of areas that are definitively missing out and I bolted
in place some time areas in the Cargol, Pong Ray,
Palmerston North for twenty four hour service because there's nothing
in those rural areas and then other areas like Lower
Heart which didn't have a daytime service, which I say
needs a daytime service because that's putting an extreme amount

(05:20):
of pressure on ED when all the general practice capacity
is full of the Heart during the day.

Speaker 2 (05:26):
How many people and you might have the status, you
might not, but you can give us an indication of
people end up an ED that don't need to end
up an ED because there's no facility for them to
go and see a GP at eleven o'clock at night.

Speaker 3 (05:39):
Look, Look, that's a good question, Nick, And it varies
around the country, and it varies on the time of day,
often overnight from eleven to eight. There isn't a huge demand.
That's what we tend to see. But what we do
know if you cannot access your GP during the day
because there's capacity or books are closed and you can't

(06:00):
get it, yes, we do know that puts successive demands
into emergency departments and it's disproportionate. So if there's a
five percent reduction in this particular area in terms of
GP capacity or ability to get in to see your GP,
there tends to be a disproportionate demand on emergency department.
So this is really really important that it is very

(06:22):
very closely connected in terms of what happens and quickly.

Speaker 2 (06:25):
Because I've got to go and you're very busy, man,
I appreciate you taking time. Doctor Brian. Betty's with us
right now. How many play I mean, this is me
telling asking you, not telling you, asking you. How many
tourists do we have and people that are actually working
and living in Wellington that aren't Wellingtonians, you know, lots
and lots of numbers that can't even get can't register

(06:46):
to see a GP.

Speaker 3 (06:48):
Yeah, and look to be fair, they tend to use
the after ours medical center. You tend to if you
work down there, you tend to see a lot of
overseas either tourists or or or people who are studying
in Wellington for what a better word, and they do
tend to present to the after Ours Medical Center for
that service. Yeah, and look, you're right. If that wasn't there,

(07:09):
the question would be where would they present. But again,
the fundamentalition I'd keep going back to this, we don't
have a potentially enough capacity in general practice. General practice
action needs to be supported to expand, to increase capacity
so that people can sign up and people can be
seen when they need to be seen during the day
to deal with problems earlier than late. And actually after

(07:33):
Ours is incredibly important and it needs to be in place,
and it needs to be a national approach which the
government is starting to take with us. And I'd sort
of say that's a good thing. We can't lose fight
site on the fact that we need to support general practice,
expand it and make it sustainable so that everyone in
New zeal To, whoever they are, can get access to
general practice when they need during the day.

Speaker 2 (07:55):
Thank you so much, doctor Brian Betty, appreciate your time
coming on Chair of General Practice in New Zealand.

Speaker 1 (08:01):
For more from Wellington Mornings with Nick Mills, listen live
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