Advocating for advocacy: Another round of speaking up for yourselves

Needless to say, it was not the return to work I was expecting

It all started on a sunny evening at a beachside café the minute I sipped on a low-alcohol beer.

A slight stab of stinging cramp in my belly that wouldn’t settle, even after a serving of banoffee pie and a quick walk around the block.

An hour later, I was lying on my bed wishing away the pain because the Gaviscon certainly hadn’t worked. Three hours later, I was lying on the cold floor of the Auckland City Hospital ED waiting room, writhing in pain and wondering if it wasn’t too late to dial 111.

Eighteen hours later, I was lying on the operating table about to have my bowels untwisted.

The following four days in hospital are a bit of a blur of observations, painkillers, fluids and chasing food. When I did think about the surgery, I had flashbacks to Braveheart and Mel Gibson being disembowelled. I guess that was the drugs talking – I am grateful for my tidy scar.

I had only been in the office after the summer break for four days before I drank that beer. Needless to say, it was not the return to work I was expecting.

Now, five weeks later, I’m back in the office, weaning off afternoon naps and catching up on the news. And general practice has been making news. The financial sustainability issues general practice leaders have been warning successive governments about for years have gained traction. Patients are waiting longer for appointments, urgent-care centres are foreshortening their hours, and a few hardy individuals are going public on the financial state of their practices.

A read through the briefing papers to incoming ministers presented by the various advocacy groups paints the broad picture.

While I was familiar with the ‘30 per cent of GPs retiring in five years’ statistic, I was caught short by the following quote in the RNZCGP’s briefing paper. “We estimate if all the GPs who are at, or over, retirement age all stopped practising tomorrow, there would be an additional 725,000 New Zealanders without a GP.”

Each organisation – RNZCGP, GenPro, Hauora Taiwhenua Rural Health Network, General Practice NZ and General Practice Leaders Forum – brought a slightly different perspective to their briefings.

General practice is often criticised for lacking a single voice. But that is a distraction. Sure, it might be easier for Te Whatu Ora and the politicians if there were one voice for general practice, but I don’t think it would be great for the sector. A single voice would struggle to represent its eclectic nature. You need only look to the demise of the NZMA to understand the difficulties in being all things to all people.

It is not a disadvantage that multiple briefing papers land on the incoming minister’s desk. For each of those papers, a group of people is passionate about the issues presented. Each of them gain insight to the issues at hand. The more the merrier, I say.

Because in today’s world getting people to join stuff is not easy. And the landscape will continue to change. When I started as editor of New Zealand Doctor in 1996, there were six groups in the advocacy space, as I recall; three of them – the NZMA and its breakaway General Practitioners Association and the General Practice Action Group are no more.

The Rural General Practice Network has widened its brief to become Hauora Taiwhenua Rural Health Network, and the IPA Network has gone through iterations to become General Practice NZ and soon Primary Care NZ. The RNZCGP remains the one constant but is much more politically active than in the 1990s. And, in addition, we have GenPro and the fledgling General Practitioners Aotearoa.

Each of those organisations offers a slightly different home for members, and when needs must, the General Practice Leaders Forum draws folk together.

There are still many GPs and GP registrars who may not feel the need to join a “club”. Maybe your peer group fills the space. Perhaps social media is your home.

As 2024 starts to ramp up and a new government brings a new political agenda, you need to think about who will represent your interests, not only for now but for your future in general practice.

Don’t delay because life delivers the unexpected.

I mean, it was a low-alcohol beer*, for heaven’s sake.

*Disclaimer: The author understands that any link between low alcohol beer and twisted tums is purely coincidental.