Need for greater collective focus on rural health
Report highlights need for greater collective focus on rural health
New Zealand Rural General Practice Network Chair Tim Malloy says the Royal New Zealand College of General Practitioners report ‘General Practitioners in Urban and Rural New Zealand’, released today, highlights his organisation’s vital role in trying to divert a potential rural general practice workforce crisis. But he warned increased support from government would be essential to both retain rural practitioners and attract new practitioners to work rurally.
Dr Malloy says that while the report has been prepared using a measure for determining rurality that differs from the measure typically used to rank rural practices in the sector, the trends are generally consistent with the Network’s own findings. From a rural perspective the report confirms that:
• While increased bureaucratic
requirements mean all GPs are working longer hours this is
likely to have the most impact on rural GPs, who are
predominantly self-employed and work full-time.
• Demands of on-call after hours care means rural GPs are working on average 14 hours per week more than their urban counterparts, who have far greater choice for after hours care provision. Some GPs working in remote practices, or in high call-out areas are working considerably longer hours than this.
• Of added concern is that while general practice is an ageing workforce in general, it is most marked in the rural North Island, with a high number of rural GPs intending to retire over the next five years.
• While nearly a third of all New Zealand’s GPs regardless of location intend to change their work status in the next five years (either by reducing hours worked, sub-specialising, leaving general practice or for lifestyle reasons) this was most marked in South Island rural GPs and could well affect patient care and service delivery in the region.
“Our focus is on initiatives aimed at retaining rural GPs, such as ensuring they are receiving the level of funding they are entitled to, targeted locum and recruitment support, assistance that will alleviate the burden of onerous after hours on-call, and reducing bureaucracy,” says Dr Malloy.
“Initiatives and incentives must adequately reflect the things that are particular to rural general practice - such as on-call duties and emergency care arrangements, the degree of isolation, traveling time from the surgery to secondary and tertiary services, dispersion and deprivation of rural populations and the distance between rural GPs and their secondary and tertiary colleagues.
“The government-funded rural locum and recruitment scheme managed by the New Zealand Rural General Practice Network has made a very real difference to the quality of life for rural GPs, enabling many to take a short term break and practices in difficult to recruit areas to remain in the face of a worldwide shortage of doctors. However, given the number of GPs intending to leave rural general practice over the next five years, long term workforce planning is essential to ensure there are enough younger GPs or registrars. This includes targeted policies to encourage medical students to take up rural general practice as a specialty.
“Access to primary health care for all New Zealanders is a key part of the government’s Primary Health Care Strategy. ‘General Practitioners in Urban and Rural New Zealand’ makes a valuable contribution by making issues facing the rural GP workforce a lot more visible. This will provide a useful platform for a collective focus on rural primary health care.”