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Patients may suffer, College of GPs warns

Royal New Zealand College of General Practitioners:

Patients may suffer, College of GPs warns

The College of GPs today criticised the three Auckland DHBs who have made major changes to the region’s laboratory service specifications without giving proper consideration to the impact the change would have on primary care.

“Accountants have focused on the dollars, and ignored the primary medical ethic of ‘First, do no harm,’ College president and Auckland GP Dr Jonathan Fox said. This follows the joint decision of Auckland, Counties Manukau and Waitemata to go to tender on a specification that reduced the current service.

The Royal New Zealand College of General Practitioners issued the statement following a meeting of the full College Council in Auckland. The College’s annual conference, ironically with a theme of Practical Solutions, officially starts tonight at 6.30pm, and continues until Sunday. “Our major concern is with the quality of care we can give our patients,” Dr Fox said.

“If we cannot get a continuation of the comprehensive, timely and precise reporting back from the labs, it is our patients who will suffer.” Auckland Faculty members were surveyed by the College in late July.

“GPs who responded cannot see the sense in changing something that was not broken. The general feeling among respondents is one of disbelief, shock, sadness, and apprehension.” Respondents were concerned that other services currently provided, such as expert advice and CME, will not play as big a part in the new service specification. The College is particularly critical of the lack of prior consultation for those most affected. “The DHBs must learn that the ‘H’ stands for ‘health’ and not ‘hospital’.

Currently they appear to be much more aware of secondary care (hospital) processes and are yet to learn that comprehensive consultation is imperative with the community. Both patients and general practice teams have been denied the opportunity to stress how fundamental such a quality service is to the success of effective primary care.” Dr Fox said Council members from outside Auckland had confirmed that where other DHBs has also changed the services in a bid to save money, the end result had been a degradation in the quality of service. “For those of us in Auckland, it confirmed our worst fears,” he said.

The College has also questioned whether DHBs followed change requirements set out in the Operational Policy Framework, specifically to consider impacts on the DHB provider arm, community and clinical views. Dr Fox said it was bizarre that, at a time when patient waiting lists are being slashed, with general practice exhorted to care for patients outside hospitals, that a world class primary care service should be put at risk.

Dr Fox said GPs would work with whoever provides the service, but were very uneasy with the potential risk to public safety from the change to service specifications. In particular the Council was concerned that these changes could result in a increase in hospital admissions. “You can’t just say ‘Sorry, we got it wrong’ when the quality of patient care is at stake.”


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