GP boycott hits diabetes care rating

A Canterbury GP boycott of the Government's "tick-box medicine" has left the region at the bottom of national ratings for diabetes care.

Canterbury sits last of the 21 district health boards (DHBs) in diabetes and cardiovascular services in the latest DHB-performance results.

The Government's diabetes-care target requires that all diabetes patients receive free annual checkups.

However, only 37 per cent of Canterbury patients were recorded as having their checkup compared with a 43 per cent target.

Canterbury District Health Board planning and funding team leader Greg Hamilton said some leading GPs were opposed to using annual reviews as a measure of good diabetes management, as patients required more than a yearly checkup.

"We have got a group who have dropped out because they don't believe that's the best way to do it," he said.

"They would strongly argue that they're managing their patients very well across the year, as opposed to a review once a year.

"We still need to work on this because we need to be able to ensure that what they are providing is doing the same job."

Hamilton said the Health Ministry was aware of Canterbury's issues, but seemed unwilling to change the targets – causing "some tension". He said despite issues regarding monitoring, Canterbury's results were "not looking fantastic. It's clearly something we would like to work on. We want to make sure we have the best service possible."

Partnership Health chief executive Jane Cartwright said Canterbury needed to prove it was providing a good standard of diabetes care.

"People will be looking at that figure and thinking we are not doing a good job; we have to show what the true story is," she said.

Cartwright said some GPs regarded the annual checks as "tick-box medicine" rather than a true measure of quality care.

Diabetes Team GP representative Dr Mike Osselton said he did not believe the DHB figures reflected the region's true diabetes care, which was good. "There's debate about whether it's worthwhile to measure diabetes care in terms of one visit per year or a series of visits over the year," he said.

Some GPs did not see the value in annual checks when they saw their patients on a quarterly basis, or believed the paperwork was not worth the $65 payment.

Canterbury Diabetes Team chairwoman Lynne Taylor said shortcomings in the region's diabetes care were mostly related to staffing. The region had the lowest number of nurse educators per capita in the country and access to podiatrists and dietitians was also a problem.

Christchurch diabetes patient Bill Abrames said he regularly saw his GP about his condition and was happy with his care. He said it would be impossible to manage his diabetes with only a yearly check.

- © Fairfax NZ News