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Get in line … 1425 patients to a doctor

Wairarapa has one of the worst patient-to-doctor ratios in New Zealand.
With 35 general practitioners [GP] serving a population of over 49,900 [2021 Stats NZ], Royal College of GPs medical director Bryan Betty said Wairarapa had one of the worst patient-to-GP ratios in the country. In fact, the region has had 35 GPs for past two years, which hasn’t kept up with population growth in that period. At current population levels, Wairarapa’s ratio is at 1425 residents for every one fulltime GP.
Wairarapa also had the highest percentage of elderly population in New Zealand
Betty said there was a nationwide shortage, particularly in rural areas.
“Rural practices often experience issues attracting workers.
“If a rural practice has one GP, there are risks of that person becoming isolated. They’re also on call for a higher frequency than urban doctors.
“A lot of practices in rural areas are closing off their books because there’s such high demand. We’ve seen it in South Taranaki and Hawke’s Bay.”
Betty said the shortage was nationwide, exacerbated by covid and flu.
“GPs are working at capacity. For our growing population, there are not enough GPs in New Zealand. We aren’t training enough, and during covid we weren’t importing overseas-trained doctors. This has caused a number of issues, and it will be a long time before this is fixed.”
He said covid lockdowns meant clinics were playing catch-up.
“Procedures such as cervical smears, mammograms, child immunisations have fallen behind because our total focus was on covid.”
Nurse practitioners are taking some of the GPs caseloads to manage the shortage.
A Masterton Medical spokesperson said NPs were the way of the future.
“Doctors don’t stay in one place like they used to. We can’t offer registration with a sole GP throughout a patient’s lifetime.
“Nurse practitioners are very highly skilled health practitioners with advanced education, clinical training and experience.”
“They can assess, diagnose and treat health problems for common and complex health conditions. This includes requesting and interpreting diagnostic testing, prescribing medications and other medical devices/treatments and referral to specialist care. They may admit and discharge from hospitals and other healthcare settings. They also integrate their holistic nursing approach that addresses the wider context of health, including person, family, and population health.”
Wairarapa has 10 NPs across seven practices. Most practices had at least one NP.
Greytown Medical [part of Five Rivers] was nurse practitioner-led but supported by GPs when required.
College of Nurses executive director and Massey University professor Jenny Carryer said the two professionals were trained differently but were both qualified.
“Nurse practitioners have the same ability to prescribe medicines and refer patients to specialists. Legally, they can do anything that a GP can do.”
The qualifying process for NPs was far from short.
“First you have to complete a three-year bachelor of nursing, then we advise being a registered nurse for at least three years. To qualify as a nurse practitioner, you have to complete a masters, which is two years fulltime, but most nurses continue working.
“My research had found patients are just as satisfied with their care from nurse practitioners. People say they feel more comfortable with consultations from NPs, they have a better understanding of their condition, and they learn how to take better care of themselves, which helps keeps them out of hospital and ED.”
She said NPs and GPs weren’t in competition, as there was “more than enough work for everyone.”
“The number of GPs produced each year is not enough. Also, GPs don’t generally go to rural areas. If we make it easier to access primary care, this will reduce hospitalisations and people admitted into emergency.”
Betty said NPs taking on patients was “not ideal” but it was important for patients to access care in the GP shortage.
“Nurse practitioners provide a very good service, but ideally should be working in collaboration with GPs.
“GPs come from a clinical background whereas NPs are from a nursing background. We still need GPs on the front line.
“There’s different training. It takes 14-15 years to become fully qualified as a GP.”
Wairarapa GPs have been under pressure since the start of winter. In July, just one practice was accepting new patients due to “unprecedented demand for services during the pandemic and increasing winter illnesses such as influenza.”
Meanwhile, a local GP said he struggled to see patients and complete paperwork and was working 12-hour days.
As of this week, there are two practices accepting enrolments – Carterton Medical and Featherston Medical.
The region also has clinics primarily made up of nurse practitioners, including First Health and Wellness Centre in Lansdowne and Pirinoa Medical Centre.

Helen Holt
Helen Holt
Helen Holt is a reporter at the Wairarapa Times-Age and enjoys reporting on a variety of topics, regularly covering Wairarapa events, tourism, local businesses, and the occasional health story.

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