GP workforce lurching toward further crisis

Dr Tim Malloy, the president of the Royal New Zealand College of General Practitioners.

Dr Tim Malloy, the president of the Royal New Zealand College of General Practitioners.

New Zealand needs to drastically increase funding for GP training or risk plunging the health sector into a deepening crisis.

Dr Tim Malloy, president of the Royal New Zealand College of General Practitioners (RNZCGP), will deliver that message to Health Minister Jonathan Coleman on Wednesday.

Malloy will also pass on messages from 350 doctors detailing the pressures of working as a GP in the current health system.

The plight of GPs has been the focus of intense debate after Waikato University and Waikato DHB revealed a joint proposal to create the country's third med school.

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The Waikato proposal aims to address the healthcare needs of disadvantaged, rural and provincial communities and reverse the country's heavy reliance on overseas-trained doctors.

Malloy said the Government currently funds training for about 200 doctors in general practice each year.

"We need to train about 300 doctors in general practice per annum to even start to break even," Malloy said.

"We believe that increasing it to 300 will go some way to solving our problem. We had 275 applicants for 180 jobs funded by the Government this year. What that says to me is that there are people looking to become GPs and we can hit the numbers if we actually had the funding to do so."

Adding to the pressure on GPs are population growth and the country's ageing population, which often has complex healthcare needs.

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"There's something like a net annual migration of 70,000 people. In GP terms, that's another 50 GPs we should be producing each year for those 70,000 people. But we're not keeping up with numbers that we currently produce, let alone that kind of growth."

The backers of the Waikato med school proposal argue the country has become too reliant on foreign-trained doctors. Many end up working in rural and provincial communities but don't stay in the country long term. 

Months after the Waikato proposal was announced, Auckland and Otago med schools revealed plans to create a national school of rural health.

The two established med schools say the school of rural health could start to address the country's chronic shortage of health professionals in rural communities and would avoid the start-up costs associated with creating a third medical school.

Waikato University Vice-Chancellor Professor Neil Quigley and Otago University medical school dean Professor Peter Crampton will present their competing proposals at the annual Conference for General Practice in Dunedin on July 28.

Malloy declined to say which proposal he preferred, but said the RNZCGP will work with whatever bid is successful.

"As someone who's directly involved in one of these proposals, I think one of the biggest risks we run is to over promise and under deliver and that worries the heck out of me," he said.

"We somehow think that this is instantly going to solve our problems and it's not, and it's not because of the legacy of 20 years of inactivity in the sector. The lag time out of either of the two proposals is going to be in the order of 12 years."

About 40 per cent of current GPs (1850 doctors) are expected to retire by 2025.

Malloy said the uneven distribution of GPs across the country, and in particular the shortage of GPs in rural communities, is a complex problem.

Research shows the chances a doctor will choose a rural career increases if the person comes from a rural background.

"It's one of the underpinning premises of some of the initiatives that are occurring in both the current system and the Waikato proposal and the school of rural health proposal."


 - Stuff


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