Dr Prabani Wood: former GP and NZ Initiative research fellow outlines the state of New Zealand's GP workforce in new report

A new report examining the state of New Zealand's GP workforce has unveiled the strain many healthcare workers are currently under.

The report, called The Heart of Healthcare: Renewing New Zealand's Primary Care System, describes an ageing, overworked cohort of GPs who struggle to maintain their business under the weight of increasing patients and operating costs.

Former GP and NZ Initiative research fellow Dr Prabani Wood says current funding doesn't cover the necessary costs to deliver the care that patients need.

"Add to that, the working conditions under which GPs currently have to work - which means that a lot of our time is spent doing vital, non-patient-facing work, such as following up referrals."

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Episode Transcript

Speaker 1 (00:00):
Brian Bridge, who would want to run a GP clinic?
The answer from today's New Zealand Initiative report is perhaps
not many. The gps who are running them are aging
and overworked. They are struggling to keep their business running
because of the number of patients they have to see,
the operating costs they are faced with, they're blowing out.
Funding is not keeping pace and the ailments that people

(00:23):
are presenting with are increasingly complicated. Doctor Prabarney Wood is
a GP and New Zealand Initiative research fellow who did
this report and it's with me now. Good evening, Good evening, Ryan,
Nice to have you on the program. Give us a
sense how hard is it to run a GP clinic.

Speaker 2 (00:44):
I have to be honest, it's pretty hard. The funding
and it just doesn't cover the costs of delivering the
care that our patients need. And add to that the
working conditions under which gps currently have to work, which
means that a lot of our time is spent doing

(01:08):
a vital, non patient facing work such as following up referrals,
looking at blood results. Those type of things that time
is not paid for, So as a business owner, you
would have to pay for your employees to carry out
that work, but then the business loses money as a result.

Speaker 1 (01:30):
You can charge a co payment though, right the co.

Speaker 2 (01:34):
Payment is only what the patient pays when they come
and see you for their appointment. So four and a
half hours of seeing patients generates about three and a
half hours of non patient facing time that's not paid
and certainly isn't covered by the money the funding you
get from the.

Speaker 1 (01:55):
Consultation, So the co payment. So what I pay when
I go plus what the government pays you. You're saying,
would I only cover the four and a half hours
patient time, not the three and a half extra roughly?

Speaker 2 (02:08):
Yes, yeah, I'd probably say that the funding doesn't even
cover the four and a half hours of the patient
facing time either. Right?

Speaker 1 (02:17):
Is that because all the doctors are creaming it?

Speaker 2 (02:21):
Oh? No, I think you talk to any GP and
I would hope you would know that that's not the case.
It's really sad that because our funding has not been
looked at and addressed for so long that GP many
GP practices have had no choice but to increase the
co payment that they charge patients. It's not something they want.

(02:44):
We want to provide an accessible service and we want
our patients to be able to come and see us
when they need to and to be able to afford
to do so what's.

Speaker 1 (02:53):
The net effective that if you're in an area where
you can push up your co payment without cutting your
nose off to spite your fight, So now I'm going
to afford to come and see you anymore. Does that
mean that you will have a better service if you
are rich and living in a night well to do
area as opposed to if you were in a poorer area.

Speaker 2 (03:13):
Yes, Unfortunately that is the case because with the way
funding works as inequity in the system, if you are
looking after a predominantly high needs population who are poorer you,
often they'll have they a community services card which makes

(03:33):
it cheaper for the patient to access to see you,
and you get a little bit more funding, but it's
certainly not enough to cover the costs of looking after them.
Whereas if you've got patients who are from a more
predominantly wealthy area, you can charge a bit more from

(03:54):
your co payment which helps cover your cost, but it's
still really at the moment, not enough to give you
an idea. And when I was trying to do write
this report, I was trying to find evidence to show
how much of our health budget goes on primary care,
and I couldn't easily find that data. But earlier or

(04:15):
last week study from Victoria University showed quite clearly that
for the last twenty years we have had an average
of five point four percent of the health budget spent
on primary care. And when you compare that to other
OECD countries, the ones that are doing well are spending
around fourteen percent.

Speaker 1 (04:36):
So that's going to cost billions of dollars.

Speaker 2 (04:40):
No, And what it means is, you know, we know
that you know, government is trying to reduce spending and
keep to budgets. What we would be asking for is
just a small repurportion of some of the health budget
into primary care. If we can't find new money, it's

(05:01):
just reassigning some of that to primary care. And one
of the ways is to look at the amount of
money you would save from preventing people turning up to
ED for instance.

Speaker 1 (05:14):
He just one final thing, because this has been a
fascinating insight. A lot of what I've read today talks
about complex, increasingly complex needs and complicated patient situations. Is
this code for obesity problems related problems what is it
getting it?

Speaker 2 (05:34):
Oh, there's any problem you can name.

Speaker 1 (05:37):
Really we are Why have we got so many more problems?

Speaker 2 (05:43):
I think, Well, one of the things is we've got
an aging population. By twenty twenty eight, we're going to
have over a million people aged over sixty five in
New Zealand. So that in itself, as you get older, unfortunately,
you're more likely to develop a chronic health condition and
or will be living with a disability. So there's that.

(06:06):
But we are also dealing with increased diabetes, that's for sure.
There's increasing mental health issues, which you've possibly talked about
at some point as well. But I think why these
issues are getting worse is because people aren't being able

(06:28):
to get in to see their usual doctor for them
to be able to pick up things early and help
support people to turn their health around.

Speaker 1 (06:37):
It's a vicious circle. Doctor Probani would gp in New
Zealand Initiative Research Fellow, really enjoy talking to you. Thanks
so much for your time. Thank you for more from
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