Editorial: Doctors at large

20:47, Jan 05 2014

It sucks to be be sick on a holiday.

It sucks a good deal worse when you discover that it's your doctor's holiday, too. This happened to large numbers of Southlanders during the New Year holidays, where it appears not a single Invercargill practice was open.

There's no way of knowing how many people simply hunkered down in their misery; nor in how many cases this decision was itself unwise or unhealthy.

Or perhaps unnecessary. The Invercargill After Hours Doctors service in the city was, of course, running.

But this service, with only one GP on deck, was itself really busy. On top of which it's potentially a pricey option for the public. Depending on the patient's age, and any reciprocal agreement their usual doctor has with the service, people could pay $100 a visit.

It's scarcely surprising that the real action, in the absence of people's regular GP services, was down at Southland Hospital's A and E department, where people flocked with their ailments.


It's a frequent lament from A and E how many people who show up not out of urgent need, but in preference to paying for a GP. That is a significant problem and it's one not lost on those who are there in more legitimate circumstances.

But the New Year influx was hardly a case of people spurning the GP option.

These people might not have suffered accidents, but it would be a weird, inadequate definition of an emergency that wouldn't include, for instance, Stacey Blackie, who had not otherwise been able to find a doctor to see her baby who was distressingly ill with a virus.

Even in what the emergency department clinical leader Adam McLeay called an "exceptionally busy" day, her baby was seen immediately.

People understand - in theory, anyway - that these departments cannot work on a first-come, first-served basis. Priorities have to be established quickly, and reassessed constantly as more urgent cases present themselves.

However, it's not easy to be sanguine about the process as the waiting time stretches on in its pain and discomfort.

In days such as this, with accident victims and the displaced GP patients arriving arriving simultaneously, atop the normal complications of holiday mishaps, it is easy to understand the pressures on hospital staff and the frustrations on the waiting public.

Did it have to be this bad?

At A and E they had boosted numbers, with at least three extra doctors each day.

That was entirely sensible. It is hard to find any trace of co-ordination within the GP community, either through one or two practices staying open, or through expanding the normal after hours service, which does seem to have been sorely pressed.

When GPs take holidays it's not some indulgence or a gesture of disregard for their patients. There's no denying that New Zealand flogs its GPs hard. This is most famously the case in rural areas, but many urban practices are also, oftentimes, under sustained pressure.

So nobody should begrudge the holidays. But whether there's been enough collective attention to minimising the public disruption is a different question.

The Southland Times