General practice of value or past its use-by date?

In print

General practice of value or past its use-by date?

Jan White

Jan White

Jan White, Chair
Jan White is chair of the NZMA GP Council

Mt Eden GP Jan White urges GPs to get involved in the discussion on the future of the health system

We must be clear there is good evidence regarding the efficiency of general practice Recent weeks have seen the editorial in the New Zealand Medi


Well said, Jan.  The undervaluing, ignoring, or worse still "top down" managing by non-representative and more often than not non-medical political appointees has to stop in order for New Zealand to improve our health system and reduce the wastage of public Health funding on bureaucracy and inefficient non-evidence based programs. Equity doesn't mean dragging everybody down to an inefficient low quality NHS type system, we should at least try to match the Australian system which values GPs.

Thank you Jan for leading the charge. The comments in Professor Werry's letter were reprehensible. It sent a cold chill through me that an opinion leader, of sorts, could have such a jaundiced view of the work that goes on in General Practice. I think we are very vulnerable to misguided and calamitous change being foisted upon us. The most recent A1 funding changes have been yet another heavy turn of a vice that is squeezing time and quality out of the consultations of those who may well need that time and quality the most. The longer our model of care is damaged by inadequate funding, the more vulnerable we will become to being reconfigured into the sort of General Practice  trash we  see in the NHS 

Absolutely agree William. "General Practice is past it's used by date if it is not properly funded".

It has not been properly funded since capitation started. Without a business case or effective representation, both things the sector lacks, there is no way I'd recommend GP as a career.

If we are to have this as a discussion we should ensure we use the right language: Government does not "fund" Primary Care, Government provides a subsidy in the form of a population based calculation rather than fee-for-service calculation to reduce the cost of access for certain users. Certain services are paid for in full (such as immunizations) and these are therefore funded, but Government does nothing to ensure the viability and sustainability of General Practice in New Zealand. They certainly do not make any investment in General Practice. I can think of several of our academics who do with some enlightenment in this regard.

Bryan .

Having just spent $5000 on replacing a 10 year old  vaccine fridge this will have  paid for itself after 500  vaccinations fully paid  at $21.00 with $11.00 for the nurses time and overheads are deducted.

 In 10 years   the same will happen again

 Immunisations are not Fully funded .



Point taken. Where is the proof that a regularly serviced, fully maintained and monitored vaccine fridge is past its use-by-date after 10 years? Something that was quietly slipped into the regulations without evidence and that adds significantly to overheads. Well at least the cost of the fridges has come down - our first one was $10K (bought when most practices kept vaccines in bog-standard fridges)