8. Hon TONY RYALL (National—Bay of Plenty) Link to this
to the Minister of Health
Is there a shortage of general practitioners in New Zealand; if so, where?
Hon PETE HODGSON (Minister of Health) Link to this
In general, no. By international standards New Zealanders have very good access to general practitioner care, and, certainly, better access than in the UK, USA, Canada, or Australia. However, the distribution of general practitioners within New Zealand is creating problems in some communities, with the Kapiti coast being a well-known example.
Why does this Government continue to count the problem, with endless reports, when Annette King herself was calling for action to keep general practitioners in New Zealand as far back as September 1999, at a time when the number of general practitioners in New Zealand was at a record high, and when year after year in her term as Minister of Health the number of general practitioners in New Zealand dropped—yet this Government continues to call for more reports?
Let me give the member an answer to his question. Since 1999 the following things have happened. The number of doctors entering medical school has gone up because the Hon Annette King increased the numbers. The number of general practitioners who are leaving New Zealand in order to pay the interest on their student loans may have dropped because, contrary to the best wishes of the National Party, this Government removed interest on student loans. But, wait, there is more! A Waikato University business school survey reminds us that since 1999, when the Hon Annette King made her comments, the profit per general practitioner owner has gone up by about 50 percent. I can further assert that for a salaried general practitioner, the value of a general practitioner has gone up since 1999, when the honourable member made her comments, by about 50 percent. What is more, between 2002 and 2003, and between 2003 and 2004—which are the latest statistics—the number of general practitioners in this country went up.
Moana MackeyWhat reports has the Minister received on factors that could lead to a shortage of general practitioners in New Zealand?
I have received reports that cuts to primary health spending in the order of $500 million would lead to increased doctors’ fees for patients, decreased profits for practices, the undermining of the long-term viability of practices, and the encouragement of an exodus of general practitioners from New Zealand. Unfortunately, that is the policy of the National Party and Tony Ryall. There is a word for those who shriek about general practitioner shortages and simultaneously plot to undermine New Zealand’s general practices.
Barbara StewartHave the Minister’s comments in May—that the health workforce was one of his main priorities for the 2006-07 year—resulted in any action as yet to head off the critical shortages in the general practitioner workforce predicted by the Medical Association in March this year?
The critical shortages that the member refers to are not borne out by the fact that general practitioner numbers have been going up in recent years. But, 19 days into the new year, I can say that we have made useful progress on the health workforce issues. I will be announcing some further details in a few weeks.
Sue KedgleyWhat is the Government proposing to do about the fact that, since 1 July, nurses employed by general practitioners now earn up to $195 a week less than nurses in district health boards, and what is the point of handing over millions of dollars to primary health care when without pay parity we may not have the workforce to implement the Government’s flagship Primary Health Care Strategy?
This calendar year the taxpayer is investing $560 million into the primary health care sector. That, coupled with the fact that the Waikato University business school survey shows that the profit per general practitioner owner is now in excess of $150,000 net of tax, would lead me to the view that both parties are to be encouraged to reach a resolution in their forthcoming negotiations.
What sense of urgency does this Government demonstrate with its own Health Workforce Advisory Committee’s final report, which states that it hopes its set of strategic principles will prompt wider discussion amongst the health and disability support sector, and lead to the development of yet another set of agreed principles, and these, in turn, will lead to the fulfilment of the Health Workforce Advisory Committee’s overall workforce vision; what does that do for the thousands of people around the country who cannot get on a general practitioner’s book, including a thousand people on the Kapiti coast, and the people of Horowhenua, where a general practitioner is now commuting from Kerikeri 3 days a week to provide service there?
The member raises two separate issues in the one question. Let me attempt to address them both. The member may be aware that during the 1990s, in the area of the health workforce, precisely nothing happened, which was why there needed to be a period of scoping and advice. The advice was provided by the Health Workforce Advisory Committee and other groups. That period has now come to a conclusion. The Health Workforce Advisory Committee will present its final report in August, at which time I will wind it up. In respect of the Kapiti situation, I am happy to advise the member that, contrary to his viewpoint, 200 people have gone on to the books of that primary health organisation in the last 4 weeks—
There was never a thousand; there was a total of about 500. The remaining 300 are being rung as we speak to see whether they have found a general practitioner. The member should get at least some facts right—one would be good.
Why does the Government not accept that, apart from a new Minister of Health, the best way to keep general practitioners and the rest of New Zealand’s workforce in this country is to cut personal taxes now?
Because to pay for those tax cuts we would need to strip hundreds of millions of dollars out of the primary health care system, we would need to put up fees to go to the doctor, and we would need to cut the after-tax profit of general practitioners. That is precisely what the National Party has in mind, and I am glad the member has outed himself on that point.
Jo GoodhewDoes the Minister not realise there is a crisis in rural New Zealand when people in Gisborne, Timaru, Blenheim, and the Kapiti coast cannot find a general practitioner to register with, when the Levin general practitioner commutes 3 days a week from Kerikeri, and when 1,900 patients from Waimate currently have no GP; it is all very well to invest millions in subsidised visits to general practitioners, but is it not of no use at all if there is no general practitioner to visit?
There are about 3,000 registered general practitioners in this country at the moment—give or take. Twenty-five years ago there were 2,000. That is what an increase looks like. In respect of rural health, it is interesting to note that the last report of the Royal New Zealand College of General Practitioners pointed out that there are disproportionately more general practitioners in rural areas than in non-rural areas. But, yes, I do acknowledge there are problems in certain parts of the country—for example, Kapiti. Certainly, there are problems in Levin—the instance that the member raised. The reason for that is that this Government has got a deinstitutionalisation policy going on from the Kimberley Centre. It will be finished in a few weeks, and this House should applaud the end of the era of institutional care.
I seek leave to table two documents. The first is a document of comments made by the Hon Annette King in September 1999—when the number of general practitioners in New Zealand was at a record high—calling for action to keep doctors.
Madam SPEAKERThe second document is a report from the New Zealand Government’s Health Information Service, which shows there are fewer general practitioners today than there were 6 years ago.
I seek leave to table a document with the results of a Commonwealth Fund International Health Policy Survey, which shows that of five nations New Zealanders have the best chance of getting a same-day appointment, and the least likelihood of having to wait 6 days or more to see their general practitioner.