Bryan Betty: General Practice NZ Chair on the increasing number of Kiwis unable to access specialist care

A concerning healthcare trend finds more Kiwis unable to access specialist care, leaving GPs to manage cases without extra resources. 

Otago University has found between 2018 and 2022, the risk of being declined referred specialist services increased significantly, by 5.2%.  

General Practice New Zealand chair Bryan Betty told Mike Hosking that the threshold seems to be changing. 

He says the bar to get in to see a specialist seems to be rising, based on the fact there's not enough capacity in the hospital to see patients. 

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Episode Transcript

Speaker 1 (00:00):
More evidence this morning than our public health system not
cranking all that well. Study out of the University of
Targo found specialist cares becoming harder to access, specialist declining
more referrals from GPS risk of being declined has risen
more than five percent a year between twenty eighteen and
twenty twenty two. General Practice New Zealand commission this research.
The Chairers doctor Brian Betty is well, it's Brian, very
good morning to you by Mike. Just confirmed for me,

(00:22):
because I've had mixed reports. Is it five percent a
year over those four years or five percent over those
four years?

Speaker 2 (00:29):
It seems to be five percent over those four years,
but it's six hundred thousand referred to specialist service a year,
so that's about eighty five thousand per year at this point.
So it's large, large numbers.

Speaker 1 (00:41):
So when yeah, it's large numbers, but in percentage, five
percent over of four years is one point something percent
per year. And although if you're on the list know
AND's happy about it, of course, but is that is
that material per se and is there something going on
or is that just sort of statistical variation?

Speaker 2 (00:55):
No, No, it's statistically very relevant. So So the thing
about is that the referral have stayed static over that
four years at six hundred thousand, So yeah, that increase
is about seventeen thousand referrals declined per year, so that
is actually really really relevant. So yeah, these are big numbers.

Speaker 1 (01:15):
And why do they Is it the money? We can't
do it, or I've had a look at your case
and the GP got a bit over anxious here and
I don't need to see you.

Speaker 2 (01:23):
No, no, I certainly not. If you go back, we
had less declines exactly the same number of ferals. GPS
refer patients for a reason. There's a reason for doing it.
They do their job, they decide they need a specialist
to have some input. There's a reason for doing it.
So GPS aren't just making this up. So no, what
seems to be happening is the threshold seem to be changing.

(01:45):
That is, the bar to get in to see a
specialist seems to be getting higher. And that's based on
the fact that there's not enough capacity in the hospital
system to see these patients.

Speaker 1 (01:54):
So they would tell me if I asked them, I'd say, yep,
I would see you if I could. But given I'm stuck,
don't have the staff, where I don't have the budget, I.

Speaker 2 (02:01):
Can't Oh, there's been a number of cases this happens
in orthopedics and we've seen this in Wellington, and I've
seen this with patients of mind where they've actually got
to see the specialist and the specialists said yes, you
need an operation. Then the hospital has actually declined the operation,
said no, we're sending you back to the GP because
we do not have capacity to do the operation. So
the problem with this, Mike, is that everyone focuses on

(02:24):
the waiting list and how large the waiting list is.
We're not focused on the eighty five thousand a year
who are to be being declined and not even getting
onto the waiting list. And that's the hidden problem in
the system.

Speaker 1 (02:36):
And that's once again the poor old GP. Because if
you've sent somebody off to do something and they can't
do it, what do you do? I mean, you know
you're start, can't you.

Speaker 2 (02:42):
Well, well, well this is the problem. So that the
problem has been pushed back to the GP, they're left
it managing a patient who's got a problem that should
be seen in secondary care. They're saying they're often working
being forced to work sort of out of their scope.
They having to manage patients with increased pain medication and
for the patient, quality of life goes down. And we

(03:03):
know from the research they have to see the GP
more often. It's costing them more money, and it's just
a bad It's bad for the system, it's bad for
the GPS, it's bad for the patient.

Speaker 1 (03:12):
That's thirty million on radiology from Shane Ready yesterday. Is
that the sort of thing that will alleviate it.

Speaker 2 (03:17):
I think that's a real step in the right direction.
I'd have to sort of applaud the government for doing this.
I mean, look, gps need access to things like radiology
in the community to do their job. It's like like
a builder not having a power drill to build a house.
You can't do your job. This has been a problem
for years. We've been explaining to the government. This is
really problematic because the only other place we can send

(03:39):
a patient who cannot afford an X ray is to
the emergency department or to the hospital. It puts extra
pressure on the hospital, so we need to sort this
problem out. This is a really really positive step forward.

Speaker 1 (03:50):
Good stuff, Bryan, you have a good weekend. Appreciate it.
Doctor Brian Betty, General Practice New Zealand Chair This Morning.

Speaker 2 (03:55):
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