Health targets are crowding out follow-up care, senior doctors' union says
The senior doctors' union says the coalition government's health targets are pushing acute care and follow-up appointments down the queue.
Sarah Dalton, head of the Association of Salaried Medical Specialists (ASMS), told RNZ's Morning Report, RNZ reported: "We would argue that the targets that focus specifically on planned care and first specialist appointments are incentivising and, in fact, forcing hospitals to focus on those things at the expense of acute care and on follow-up appointments."
In Wednesday's Morning Report health debate, Labour's Ayesha Verrall confirmed Labour would keep the coalition government's health targets if elected, RNZ reported.
Dalton named the patients she says are missing out, according to RNZ. One group is people with chronic medical conditions, particularly those who rely on physicians, combinations of medications and monitoring over time. The other is mental health patients who need regular contact with psychiatrists and their teams.
Dalton also said no one was speaking in a "meaningful way" about specialist doctors, which she said includes GPs, RNZ reported. According to RNZ's programme summary, ASMS welcomed the attention on nurse and GP shortages but wants parties to also consider how to bolster the specialist workforce.
She was blunt about the parties' interest in health workers who aren't doctors. "I think the focus on non-doctor healthcare is more about cost-cutting and a refusal to engage in the challenges of recruiting to hard-to-staff areas rather than what's best for patients," she told Morning Report, RNZ reported. "If we want a health system that is responsive and safe, it needs to continue to be led and staffed by senior doctors and dentists."
In the debate, Health Minister Simeon Brown said the health system was "heading in the right direction" and pointed to the new Waikato Medical School. RNZ reported the school is set to train another 120 doctors a year, with the first cohort entering in 2028. Dalton welcomed it, but said the results would not be felt for another 10 to 15 years. She gave Labour credit for its policy focus on moving acute patients through hospital faster.
Verrall admitted during the debate that some of Labour's "three free GP visits" could be with a nurse practitioner rather than a GP. She said Labour would bring in "efficiency improvements", such as a triaging system, to reduce acute demand. Brown said Labour's policy would "clog up" the health system and called on the party to release the modelling it says shows how it would free up four and a half million appointments.
Northland
In Whangārei, GP Geoff Cunningham told RNZ that Northland has a major workforce shortage. About 25,000 people in Northland aren't registered with a GP, he estimates.
"We've struggled to recruit and retain GPs up here," he said. "GPs will earn a lot less in Northland for working a hell of a lot harder than they will for working in cities."
Cunningham said he had not seen any politician properly address a "beyond broken funding model". It takes 12 years of training to become a general practitioner, he said, and the job needs attractive pay and conditions if doctors are going to choose it.
His verdict on the Verrall–Brown debate: "like listening to two seagulls fighting over the last chip".
He thinks a better approach is already within practices' reach: triage patients in the morning, including phoning them to see whether a problem can be solved without an in-person appointment. He said that works more often than telehealth.
Artificial intelligence won't fix the shortage either, in his view. It is not "the great panacea for general practice", he told RNZ.
"It's just a dictation service, really, for note-taking... it might just get you out the door at the end of the day, probably about 10 minutes sooner."