Seven years after the promise of a funding review, the sector is no closer to seeing changes and instead finds itself sidelined while Te Whatu Ora is the only show in town
It’s bright yellow and there’s a perky stethoscope on our latest cover. It might be a case of fake it until you make it, but I resisted choosing a serious story to head our last issue for the year and spurned a string of headlines about dumped contracts, funding cuts, budget losses, Treaty breaches and any more of the ephemera of 2024.
A few weeks back, I had this idea that instead of a catalogue of misery, the Summer Edition would be all about joy. Yeah, right. I sense the collective eye roll – it was a bit like that here in the office.
A reporter would pitch a story, and I would ask, increasingly tentatively, “Is there any joy in this story?” The aforementioned reporter would look at me with sage forbearance, and the rest of the team would glance sideways.
That’s not to say there is no joy in this issue – there is plenty – from a new practice in Ōtaki and the results of our Sizzling Summer Survey to the return of the fab four from 2006, four GPs we interviewed 18 years ago, at the time some of the youngest RNZCGP Fellows, now mostly practice owners.
There is joy in Parekawhia McLean’s mission to see the Hauora Māori Advisory Committee make a difference, joy in Tim Tenbensel’s teaching and joy in Lucy O’Hagan’s placard for the hīkoi, even if she didn’t quite make it to Parliament.
And when all else seems lost on the joy front, along comes specialist GP and glass-half-full bloke Jo Scott-Jones with his advice on finding joy, aka How to treat Joylessness.
But as much as we can find joy if we go hunting, I don’t want to paper over how confronting the continuing upheaval in the health sector has been and how much is still to come.
Seven years after then-health minister David Clark promised a primary care review, the sector is no closer to seeing changes to funding and instead finds itself sidelined while Te Whatu Ora continues to be the only show in town.
Current estimates suggest it will be mid-2027 before the agency is out of deficit. Even if the funding formula is updated, there will be little new money out of the current health budget for the sector until at least 2028. Earlier than that would require an overt political decision to shift investment.
In the meantime, primary care must manage the reality of 30 per cent of the GP workforce retiring and inequitable pay rates making the sector unattractive for nurses.
On the upside, at a recent primary care conference, I heard most people reporting their organisations were just getting on with it and, as much as possible, sidelining Te Whatu Ora due to the difficulty in getting anyone in the organisation to make a decision.
Ironically, given Māori health organisations have felt the impact of the Coalition Government’s drive to ditch health initiatives related to ethnicity, in primary care it is the iwi Māori partnership boards decreed by the Pae Ora (Healthy Futures) Act 2022 that are forging ahead despite any clear indication of the resources they will receive.
Mostly, the GPs and general practice staff we talk to love their work, but they are tired and increasingly frustrated that the simplest of interactions with secondary care is seldom straightforward and so often they are made to feel like an irritating annoyance as they advocate for their patients. Yet, as has been said so many times before, primary care has the answers to reducing pressures on hospitals, keeping people well in the community and ultimately saving the Government money. Does it have to be so difficult?
