VOX POP: What pushed your buttons?

Happy

We have not had any COVID cases in Gisborne in 2021.

Angry

Being stuck with the mask exemption responsibility with nil warning

Happy

The team getting up and running with our offsite vaccination centre. Great input from community as well. Targets met, including for Māori. And my most complex patient of the last 18 months cured with ECT. Return of a lost soul!

Angry

I don’t really do anger, but was somewhat annoyed that the codes for Pfizer vaccine in Medtech and Indici are different, so GP2GP doesn’t transfer them properly. How can that happen in this day and age?

Happy

What has made me happy is the accumulation of relationships through work, with other GPs, the PHOs and DHBs, the communication and the project management. That has been the most pleasant thing, the incredible relationships that have been formed, it fuels me.

I have been impressed with the collective team response too, we all make up small parts of the bigger picture. We’ve done remarkably well, and we need to make sure we recognise that.

Angry

I have been frustrated to the extent at which misinformation or disinformation around COVID-19 and vaccination has spread.

It is a minority [viewpoint that is circulated] but still has lots of attention, which harms my patients. We’re talking a matter of life and death.

Happy

I have been generally happy with New Zealand’s response to COVID-19, we got through 2021 and we’re not living in Auckland! At Village Health Lincoln Road [in Christchurch] we have an amazing and committed group of people who have pulled together in the last two years and made this journey bearable and even fun sometimes. I also breed Burmese cats, it’s quite technical at times, and makes me happy.

Angry

Endless amounts of paperwork and where everything and everyone delegates to the GP, patients with unrealistic expectations and difficult patients who won’t get vaccinated, who are going to potentially cause heaps of work in 2022 when they get COVID-19.

Happy

COVID-19 is a massive team thing, which sees the whole of general practice – receptionists, nurses, GPs – working together to keep everyone safe. We’re all so dependent on each other, that the moment someone goes AWOL, you’re in real trouble, but it’s also worked to bring the team stronger and closer together.

Angry The continued attitude about general practice makes me angry. There is a constant sense of alienation from the thinking in Wellington of the role of general practice, with just one illustration after another.

The health reforms will make no difference. We’re already under so much pressure, it would take something pretty cataclysmic to change that. I’m all about evolution, not revolution.

But we’ve seen it all before, and there is no El Dorado – so there’s a fair bit of panic in general practice at the moment. The sharp end is only just starting – but we have shattered and exhausted health workers – it’s not a cheerful prospect.

Happy

Making me happy are the usual things – my family, friends, children, my dear old elderly mother and my animals. Also, my excellent staff at work. Work is hard yakka and we are so busy but it's great working with a great team who are supportive of each other. I’m also grateful for living in New Zealand and having a government that has steered us through, I think pretty safely, a terrible time. I’ve also been cheered up by a little online shopping with a few slightly extravagant purchases – some earrings and a pair of amazing Missoni trousers.

Angry

The first thing that made me angry this year was the politics in America. The insurrection and the crazy way that the GOP [Republican Party] is behaving has made me really angry. As I think it’s not just about America it’s about the rest of the world and we are going to suffer because of right-wing politicians’ vanity and desire for power.

Closer to home, the infiltration of some of those crazy right-wing, conspiracy theories coming into New Zealand and infecting our population. You are now seeing Trump flags and similar at these anti-vax and anti-mandate rallies. And that makes me angry because that is not how I think of New Zealand being. The whole disinformation and misinformation situation makes me despair and makes me bloody angry as well.

Also, madness of the internet and social media that allows this kind of stuff to spread and damage the social cohesion of not just our country but other countries. And I worry where it might lead.

Happy

We are hopeful the Māori Health Authority will give Māori providers more autonomy regarding how best to support whānau.

As a Māori provider, our focus is on whakawhanaungatanga and ongoing support within our network. We are kaupapa driven and our commitment is beyond what we get paid to do; we look after everyone, and have a “do whatever it takes” attitude which isn’t reflected in current funding models.

Also, Whānau Ora freeing up resources for Māori providers on the front line – we have seen how much this flexibility has helped whānau cope in lockdown.

Angry

The slowness of government agencies to move at the beginning of this last lockdown, given their experience of the last lockdowns, and their need to hold on to the power and systems that create inequities.

Happy

In a year consumed by COVID-19, it is difficult to focus on anything else. What made me happy in 2021 were the geographical lockdown measures put in place from August to try to contain the virus. I am a nurse practitioner working in MIQs in Auckland, so I can easily appreciate that the health system would have not been able to cope without those measures.

The year has been challenging for the primary healthcare workforce. As I am a locum NP, 2021 has been intense workwise, especially since I work across the country. In a year that has been challenging for all, I am hugely grateful to my whānau for just being who they are.

Angry

What made me angry? Genuinely irresponsible and selfish citizens disregarding the rules of the lockdown; now their self-isolation is having devastating effects on the collective.

Happy

Professionally, the thing that has made me happiest this year has been the opportunities provided to me by my senior colleagues. Sitting on clinical governance groups, joining in PHO clinical lead meetings and possibly the ultimate highlight, taking on a good chunk of the task of setting up a new Youth One Stop Shop (YOSS) clinic in Porirua (it’s called The 502 and this may or may not double as a shameless plug). Navigating policies, chairing meetings and coordinating relationships and outreach between primary and secondary care, all with the aim to generate a service that provides wrap-around care for some of New Zealand’s most vulnerable rangatahi, has been beyond what I could have imagined I’d have the opportunity to do as a GPEP2.

I’m constantly reminded of the collegiality of this specialty and these experiences have only cemented my place in this wonderfully diverse career.

Angry

I’m T-minus 11 days from marrying a diplomat, so I’ll start by saying anger is an emotion I rarely feel. What I think 2021 has continued to show us, however, is the pivotal role primary care (and general practice) plays in managing the health of the population.

COVID swabbing, COVID vaccination, and more recently COVID care in the community, are all examples of the heavy lifting primary care can and will continue to do, to keep people safe. As someone relatively new to the world of general practice, there seems to be a bit of a disconnect between the higher level planning and implementation and what works for boots-on-the-ground primary care. The hoops a number of practices had to jump through to become accredited in COVID vaccination is one example, the stories of delays with GP notification/involvement/resourcing in management of COVID-positive patients in Auckland is another. What I would love to see is inclusion of primary care and general practice from the outset and for that involvement to begin to align with the proportion of the load general practice and primary care are likely to carry.

Fiona Cassie, Martin Johnston, Zahra Shahtahmasebi and Alan Perrott