The Royal New Zealand College of General Practitioners has today released the results of its biennial Workforce Survey showing that changes need to be made at a Government level to ensure the sustainability of community medicine in New Zealand. See the Workforce Survey: https://tinyurl.com/2020WorkforceSurvey
Aging and retirement intentions
The College has previously highlighted the serious issue of burnout amongst GPs and rural hospital doctors with the Workforce Survey showing that burnout levels were at 31 percent in 2020, up from 22 percent in 2016. That coupled with the numbers of GPs who intend to retire in the next five years (31 percent) and within 10 years (49 percent) show that urgent action from Government is required if we are to avert a community health crisis in New Zealand.
Rural communities at risk
A significant portion of the shortage issue will fall with rural communities and doctors working in rural hospital medicine. Nearly a quarter of this group are older than 60 with 15 percent intending to retire in the next one-two years, which increases to 29 percent of the rural hospital medicine workforce intending to retire in the next five years. Earlier this year the College introduced a prior specialist pathway that will help doctors train faster to become rural hospital doctors if they’ve already specialised in emergency medicine, primary care, or internal medicine.
President Dr Samantha Murton says, "The College’s recent prior specialist pathway initiative, and this month’s win with Immigration New Zealand that overcomes some of the barriers to overseas-trained doctors entering the country won’t be enough to serve even the current needs of rural New Zealanders."
The diversity of GP trainees might have increased recently but the representation of Māori and Pasifika GPs is far from where we needs it to be, which Dr Murton described as, "unacceptable."
GPs identifying as Māori made up four percent of respondents (much lower than the national population, which is 17 percent), and Pacific people made up 2 percent of our workforce while nationally they make up 8.1 percent.
Dr Rachel Mackie is the Chair of Te Akoranga a Māori, the College’s Māori GP group and says, "these kinds of low numbers come from the long-standing disadvantage and injustice that New Zealand society and systems have placed on Māori."
"We need to support and value policies that encourage more Māori students into medical school programmes, like those at the University of Otago that have been highly successful in increasing the numbers of Māori graduates but that was recently put under threat with a single legal challenge."
"I also want to acknowledge the role of Professor Colin Mantell who has been a long-time advocate and supporter for getting more Māori graduates into The University of Auckland."
"The success of these policies, which includes supporting more Māori medical graduates, is what will help address equity issues; Māori succeed when there’s a level playing field," she says.
Dr Murton says, "We are a long way off population parity for indigenous people and frankly that’s not good enough.
"We have so many bright Māori rangatahi and I’d encourage those people into medicine, and general practice, which is a fulfilling and challenging career that will make a difference for their people."
"Our health system is rife with disadvantage for indigenous people. As well as encouraging more Māori to become doctors, the College is actively enabling all GPs to increase their cultural competency and understand tikanga, cultural safety, whānau and iwi, and how best to support the communities and their health needs," she said.
Gender pay gap
Also concerning for the College were the gender pay gap figures. The gender pay gap of 14.6 percent for GPs in 2020 is much higher than the national average of 9.3 percent.
"We study for at least 11 years to become specialist general practitioners," says Dr Murton.
"It’s just staggering, and unacceptable, to me that our female GPs are being paid at a lower rate than our male counterparts, for the same job."
Significant change needed for the sustainability of general practice
"The 2020 Workforce Survey says to me that we need to see some significant and fundamental change happening if we’re going to sustain the health of the nation," says Dr Murton.
"This is exactly what I said to Health Minister Andrew Little when the College met him in March.
"The landscape of general practice has vastly changed in the last 30 years; patients have increased needs and they’re more complex, and our administrative burden is overwhelming, however the funding formula based on a 15-minute appointment has not changed in all that time and makes general practice unsustainable.," says Dr Murton.
"Not having enough GPs is one thing but settling for a situation where our highly skilled labour force is overworked, burning out, and/or retiring early in the face of that is untenable.
"The Government has a once in a generation opportunity with the Health and Disability System Review to create a resilient community health-based system, by reshaping general practice and rural hospital medicine into a formula that will lead all New Zealanders into a healthy future." she says.
About the survey
The College’s Workforce Survey is a biennial event that provides data and trend information on retirement, income, employment status, working hours, and demographics.
In 2020 the survey had a response rate of 60 percent, which comprised 3117 Fellows, Members and Associates of the College and the Division of Rural Hospital Medicine.
The 2020 General Practice Workforce Survey was contracted to Allen + Clarke who worked with staff members from the College.