‘Just come clean and say you don’t want doctors involved in primary care’: Contraception training funding excludes GPs

General practitioners (GPs) are being excluded from funding that would help more people get important healthcare, says GP membership organisation General Practitioners Aotearoa (GPA).

Te Whatu Ora Health New Zealand funding for trainers explicitly excludes most GPs.

The LARC Train-the-Trainer course is a course for health practitioners who put in long-acting reversible contraception devices (LARCs), and want to learn how to train others to do so.

LARCs are “fit and forget” contraception devices such as arm implants and intrauterine devices (IUDs) including Mirena and Jaydess.

As well as preventing unwanted pregnancy, these devices can help with excessive bleeding and conditions such as endometriosis.

Thanks to funding, LARC Train-the-Trainer courses are free for midwives, nurses, and “health practitioners” working in a rural practice or in one of a list of specified priority practices.

“This is offensiveness on steroids,” says GPA interim chair Dr Buzz Burrell. “Our members have made us aware the funding doesn’t extend to them, and they’re upset about it.”

The course costs $650 or $800, depending on whether the doctor is a member of the New Zealand College of Sexual & Reproductive Health.

Funding for the course fees should be the very minimum Te Whatu Ora does for doctors, Burrell says.

“Most midwives, nurses and hospital doctors are paid by their employer, often Te Whatu Ora, for the day to attend courses like this,” he says.

“GPs on the other hand, usually have to take an unpaid day off work to attend, and if they’re a practice owner they have to pay a locum to fill in while they’re away.”

Attending a course can easily put a GP thousands of dollars out of pocket.

“Te Whatu Ora should be paying not only the course fees, but a day’s salary as well,” Burrell says.
Having more doctors trained as LARC trainers would benefit the primary health community and the public.

“It’s a clear message to the community that the government is no longer interested in having GPs involved in urban care,” Burrell says.

“The government is saying doctors are too expensive, but the research says the opposite.”

GPs are one of the most cost-effective parts of the health system.

Well-trained and supported GPs manage illnesses before people get sicker, and prevent unnecessary hospital visits and specialist referrals.

“And the icing on top is the fact that the wording of this government funding doesn’t even have the grace to call us doctors or GPs,” Burrell says. “What on earth is a health practitioner? Just come clean and say you don’t want doctors involved in primary care.”