A high profile case occurred in Lower Hutt where the High Street Health Hub - now managed by Green Cross - has closed its doors to in-person appointments. They have 9,000 patients on their books. Sick people are going to either the After Hours clinic which is open from 5.00pm to 10pm, or to the Emergency Department at the Hutt Hospital. Queues at the After Hours reportedly stretch down the road prior to opening time. "It's a circus" was a firsthand report I heard from a patient waiting in the Hutt Hospital Emergency Department.
I didn't expect to find myself alongside her. 'People shouldn't be turning up at ED unnecessarily' was my former take on the situation.
But I had developed a blistering rash around my left eye. Three days in (Wednesday) I tried for a doctor's appointment via the phone but was told a GP was only available on Tuesday or Thursday in the morning and I would have to ring back the next day. Next port of call was the pharmacist, who refused to sell me any cream or ointment as she suspected I may have shingles. She advised I get medical help. This time I walked into the GP surgery and asked if I could book an appointment for the following morning. No. I could try my luck tomorrow morning but no appointment could be booked in advance. But she could see my eye was a problem as I relayed the pharmacist's advice. She consulted with the nurse who had said over the counter, "We are only operating a triage system. You will have to go to After Hours or ED. Because it is near your eye you shouldn't leave it." This made no sense to me. I was being told medical attention was urgent but that it would not be provided there, my local surgery of 30 years. You can only stand your ground so long.
I duly drove myself to ED and arrived at 2pm. The place was packed. I was picking up snippets of conversation to the effect that wait times to see a GP were a month or more. That the After Hours was even worse than ED. That course of action had already been tried and abandoned.
Age-wise there was a cross section of people waiting for help: a fair number of distressed parents and babies, and a fair fewer older people in wheel chairs. But everyone was exceedingly patient and well-behaved.
The reception staff were efficient and warm. Two or three times they asked that anyone who wasn't a patient stood or waited outside due to seating shortages. Nobody grumbled. Patients were checked for BP, temperature and pulse rate not long after arrival but warned that the wait times were around 6 to 8 hours. As shifts changed, announcements were updated. Everyone was kept in the picture. After 8 hours a nurse sorted through the files of those who had been there throughout (a number had given up and left) and vital signs were re-checked. I was also offered sandwiches and pain relief.
About midnight a medical staff member came out and said they were at capacity and thanked everyone for their patience and courtesy to staff. PA announcements were also made staff-to-staff that intensive care could not accept any further admissions. There were also incoming trauma cases for resuscitation.
For a few hours it seemed nobody was processed though obviously unseen ambulances would also be ferrying people in. Surrounded by people whose need was greater than mine I accepted my wait would be longer. People were generally in reasonably good spirits and looking out for each other. As I drifted in and out of sleep, I Iistened to a mother telling her adult sick daughter about what is was like was she was "growing up." "You could ring for a doctor's appointment and get one on the same day - or next day at worst. And you were even offered a range of times!" The trip down memory lane probably wasn't making her daughter feel any better.
But that is the primary health system which most of us were familiar with. It has disappeared. At least it has where I live.
At 3.30am my name was called. The doctor was profusely apologetic about the wait. I was just happy to be seen. The suspected shingles had not progressed to the actual eye and a script for anti-viral medication was written. I was advised to return if the rash or my vision worsened (my heart sinking at the thought of another 13 hour wait).
My own GP could have done the same in ten minutes. That would have saved all of the additional attention and resources required at the hospital.
Workforce shortages appear to be part of the problem, though Green Cross seems to have its own share of management issues. Unfortunately the company also now runs my local healthcare centre which has significantly reduced in doctor numbers and hours of care provided.
It seems the doctors we train no longer want to be GPs. They want to work in hospitals. Or overseas where student loans can be repaid more rapidly.
If the demands on primary healthcare were reducing, the problem might be less serious. But our increasingly top-heavy population will only increase demand.
According to Royal NZ College of General Practitioners in a 2023 briefing to incoming Health Minister Shane Reti:
I didn't expect to find myself alongside her. 'People shouldn't be turning up at ED unnecessarily' was my former take on the situation.
But I had developed a blistering rash around my left eye. Three days in (Wednesday) I tried for a doctor's appointment via the phone but was told a GP was only available on Tuesday or Thursday in the morning and I would have to ring back the next day. Next port of call was the pharmacist, who refused to sell me any cream or ointment as she suspected I may have shingles. She advised I get medical help. This time I walked into the GP surgery and asked if I could book an appointment for the following morning. No. I could try my luck tomorrow morning but no appointment could be booked in advance. But she could see my eye was a problem as I relayed the pharmacist's advice. She consulted with the nurse who had said over the counter, "We are only operating a triage system. You will have to go to After Hours or ED. Because it is near your eye you shouldn't leave it." This made no sense to me. I was being told medical attention was urgent but that it would not be provided there, my local surgery of 30 years. You can only stand your ground so long.
I duly drove myself to ED and arrived at 2pm. The place was packed. I was picking up snippets of conversation to the effect that wait times to see a GP were a month or more. That the After Hours was even worse than ED. That course of action had already been tried and abandoned.
Age-wise there was a cross section of people waiting for help: a fair number of distressed parents and babies, and a fair fewer older people in wheel chairs. But everyone was exceedingly patient and well-behaved.
The reception staff were efficient and warm. Two or three times they asked that anyone who wasn't a patient stood or waited outside due to seating shortages. Nobody grumbled. Patients were checked for BP, temperature and pulse rate not long after arrival but warned that the wait times were around 6 to 8 hours. As shifts changed, announcements were updated. Everyone was kept in the picture. After 8 hours a nurse sorted through the files of those who had been there throughout (a number had given up and left) and vital signs were re-checked. I was also offered sandwiches and pain relief.
About midnight a medical staff member came out and said they were at capacity and thanked everyone for their patience and courtesy to staff. PA announcements were also made staff-to-staff that intensive care could not accept any further admissions. There were also incoming trauma cases for resuscitation.
For a few hours it seemed nobody was processed though obviously unseen ambulances would also be ferrying people in. Surrounded by people whose need was greater than mine I accepted my wait would be longer. People were generally in reasonably good spirits and looking out for each other. As I drifted in and out of sleep, I Iistened to a mother telling her adult sick daughter about what is was like was she was "growing up." "You could ring for a doctor's appointment and get one on the same day - or next day at worst. And you were even offered a range of times!" The trip down memory lane probably wasn't making her daughter feel any better.
But that is the primary health system which most of us were familiar with. It has disappeared. At least it has where I live.
At 3.30am my name was called. The doctor was profusely apologetic about the wait. I was just happy to be seen. The suspected shingles had not progressed to the actual eye and a script for anti-viral medication was written. I was advised to return if the rash or my vision worsened (my heart sinking at the thought of another 13 hour wait).
My own GP could have done the same in ten minutes. That would have saved all of the additional attention and resources required at the hospital.
Workforce shortages appear to be part of the problem, though Green Cross seems to have its own share of management issues. Unfortunately the company also now runs my local healthcare centre which has significantly reduced in doctor numbers and hours of care provided.
It seems the doctors we train no longer want to be GPs. They want to work in hospitals. Or overseas where student loans can be repaid more rapidly.
If the demands on primary healthcare were reducing, the problem might be less serious. But our increasingly top-heavy population will only increase demand.
According to Royal NZ College of General Practitioners in a 2023 briefing to incoming Health Minister Shane Reti:
"We estimate if all the GPs who are at, or over, retirement age all stopped practicing tomorrow, there would be an additional 725,000 New Zealanders without a GP.When waiting times are at an all-time high and practices are closing their books to new patients, having this many people searching for a new GP is unacceptable and goes against everything that our workforce stands for as we strive to provide complex, comprehensive, timely and equitable care for our communities."
So the Hutt experience isn't unique. In fact it would appear representative.
Depressingly, it is hard to envisage what would dig us out of this hole. Primary care looks like a row of dominoes. But there is no point or justification in getting angry with those who remain as GPs under the stress and strain. Their staff are understandably trying to gate keep them from more.
But standing at the gate the message received is, "If you get sick - you're on your own."
Lindsay Mitchell is a welfare commentator who blogs HERE. - where this article was sourced.
12 comments:
The doctor and dentist shortage appears to be greater than Parliament can fix , Therefore the public have to demand that training to be doctors and dentists is free tuition each year that the highest standard of training is achieved by the student . This does not include any ethnic ,ideological or natural training as a quasi doctor but one standard for all NZ.
A national disgrace.
@Basil Walker - this would not fix the issue. We have a limited number of doctors we can train in NZ every year. A limited number of placements at medical schools, because medical schools need staff to deliver that training and we dont have enough. We cant even just open a new medical school as some have suggested as we would not be able to staff it. We are already training as many as we can.
"It seems the doctors we train no longer want to be GPs"
Make it attractive enough and they will want to be GPs. It's really simple to hold onto these graduates actually. Pay them really well, and give them flexibility. I'd rather us keep a Doctor in NZ who only wants to work 20 hours per week than lose them entirely to a foreign opportunity. I have read in some of these articles recently statements from GPs saying they were loaded down with too many patients and couldn't provide quality care to them so they just left. If a GP doesnt want to see back to back patients in 15 minute sessions all day, then relax their schedule and give them longer appointments and more breaks. If that is what it takes to keep them, then why not do that? I'd rather us keep a doctor seeing 20% fewer patients per day than lose them entirely!
The entire medical system is a train wreck. It isn't just ideology over race but also ideology against natural cures and immunity.
People have been told that home cures are rubbish and self-care dangerous. As a proponent of naturopathy I visit doctors very infrequently. I believe in 'you are what you eat' and are very careful in my diet. I avoid pharmaceuticals like the plague.
The internet is a rich source of information and it is not wrong to responsibly consult it for any problem. Some sites have several conventional specialists who will give you advice on your condition. Once you have a diagnosis you can then
look for natural cures. There are a surprising number of OTC ( over the counter) cures, supplements and dietary alternatives that have had rigorous double blind research with meta studies available.
Medicine needs to see the ideology of allopathic medicine they are snared in which includes ridiculing home remedies and nutrition. More people are killed by medical misadventure than self- prescribing of supplements.
It seems that the rapid increase in population has outstripped our doctor training capacity. If we keep immigration at its present levels the problem will only get worse. Of course the last 4 years has greatly exacerbated health problems in this country.
@ Erica - naturopathy is quackery. end of story. and you would be hard pressed to find a doctor in this country that doesn't promote good nutrition for health, so I don't know where you get the idea that they ridicule it. Unless of course by nutrition you mean some sort of junk ideas like eating oranges to cure cancer.
@Anonymous, GP's get next to no training on nutrition during their education. They are trained to dispense pharmaceuticals. Their entire business model is based upon making money from treatments that mask symptoms rather than providing cures and so-called preventatives that make you sick. Surgery and emergency medicine have their place, but most of our healthcare system has nothing to with health or true medicine which is restoring imbalances in the body and bringing it back to vital health.
I don't know what you Anon.12.42 think naturopathy is is but I find it hard to believe how concentration on diet and exercise and other lifestyle .modifications would qualify as quackery. According to an article last year in Time magazine there is a drive to have doctors trained more in these areas since the average amount of time of 11 hours in a course of 4 years is not considered anywhere near enough.
There are many problems with allopathic medicine ,not the least being the many side effects of pharmaceuticals as well as focusing on symptoms rather than curing the root cause of the disease.
For a doctor to become thoroughly conversant in nutritional medicine, they have to go to Australia to train. NZ, unfortunately, doesn't have courses on it. I believe NZ has a very high rate of obesity in the population. This is alarming.
There is some acceptance of eg vitamin C, but over the years I have been ridiculed by doctors for suggesting it, yet recently the University of Otago has done research and observed its benefits.
Perhaaps due to " climate change" they don't want people living all that long. Otherwise you would never let things get to this stage. One does wonder.
If only they accepted all the unvaccinated doctors and nurses back into work maybe this would help alleviate the shortage?
Even the 15 minute appointment you wait a month for (Lindsay and I share the same medical centre) tends to be a farce. The doctor spends most time looking at the screen rather than you and the glance you are given tells little. You are promptly prescribed medication and a blood test and sent to the local pharmacist. Results from the test are not explained and you may go on with the medication for months, even years, without them being monitored. My wife persevered with 5 pills a day for several years for her growing dementia and after a recent event dealt with after a 7 hour wait at ED the first step taken in her care was to stop taking 3 of them. The desperate way some turn to "snake oil" may even be better than risking "medical misadventure."
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