Over 80% of General Practices will not be offering services to support End-of-Life Choice/Assisted Dying

Assisted dying will become legal from Sunday 7 November 2021. This means that a person with a terminal illness who meets the eligibility criteria can request medication to relieve their suffering and end their life – as per the results of the 2020 referendum on the Government’s End of Life Choice Act 2019 (the Act).

However, according to an urgent poll undertaken by the General Practice Owners Association (GenPro), the national representative body for general practice across New Zealand, over 80% of general practices will not be providing the service.

GenPro’s chair, Dr Tim Malloy, said, “Despite the imminent introduction of this extremely sensitive service, the Ministry of Health did not consult with general practice owners regarding the terms and conditions which will underpin the services – which we saw for the first time when they were publicly published last month (October 2021). At that stage, we received initial feedback from our members that the terms did not support the resources and time required to provide the services that patients will expect. We formally relayed those messages back to the Ministry of Health”.

The Ministry response received by GenPro advised that no changes would be made to the published terms. “This prompted us to undertake an urgent poll of our members – who have the option of whether or not they provide the services required to support the Act - to see how widespread a problem this was likely to be. The results were significant and indicated that many patients will likely find it prohibitively difficult to access the services, and those that can will more-often-than-not be faced with doctors and nurses with whom they are not familiar and do not have an established relationship.” said Dr Malloy.

The poll results supplemented GenPro’s own analysis which identified that:

· The funding offered does not cover the General Practitioner (GP) time required to appropriately undertake the service

· The terms proposed create a significant, and unjustifiable inequity between GPs and Psychiatrists

· There is no agreed mechanism for increasing fees to cover future inflation and rising costs.

GenPro believes that the situation could have been avoided by an open and transparent consultation process to agree appropriate resourcing levels for the provision of a safe and sustainable service – an offer which GenPro has repeatedly made to Ministry Officials and which, according to Whangarei GP and general practice owner, Dr Geoff Cunningham, “..does not bode well for the oncoming expectations of COVID management in the community by general practice operators who are again being left out of any consultation or agreement regarding the resources required to safely care for their patients, their whānau and their communities”.

GenPro’s Survey:

GenPro’s survey was undertaken between 29 October 2021 and 4 November 2021. Responses were received from owners* of over 100 general practices. The results include:

· 82.5% of respondents said they would “..not be providing the service”

· The reasons given include:

o The terms of the Notice make it uneconomical to provide the services

o There is too much risk due to the lack of guaranteed fee increase

o Ethical reasons

o Lack of capacity to provide the services

· Of the 15% who indicated they would likely provide the services, over 80% stated that they were not happy with the terms being offered but wanted to, or felt obliged to, provide the services for their patients.