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Speaker 1: Brian Bridge, who would want to run a GP clinic?

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Speaker 1: The answer from today's New Zealand Initiative report is perhaps

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Speaker 1: not many. The gps who are running them are aging

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Speaker 1: and overworked. They are struggling to keep their business running

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Speaker 1: because of the number of patients they have to see,

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Speaker 1: the operating costs they are faced with, they're blowing out.

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Speaker 1: Funding is not keeping pace and the ailments that people

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Speaker 1: are presenting with are increasingly complicated. Doctor Prabarney Wood is

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Speaker 1: a GP and New Zealand Initiative research fellow who did

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Speaker 1: this report and it's with me now. Good evening, Good evening, Ryan,

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Speaker 1: Nice to have you on the program. Give us a

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Speaker 1: sense how hard is it to run a GP clinic.

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Speaker 2: I have to be honest, it's pretty hard. The funding

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Speaker 2: and it just doesn't cover the costs of delivering the

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Speaker 2: care that our patients need. And add to that the

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Speaker 2: working conditions under which gps currently have to work, which

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Speaker 2: means that a lot of our time is spent doing

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Speaker 2: a vital, non patient facing work such as following up referrals,

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Speaker 2: looking at blood results. Those type of things that time

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Speaker 2: is not paid for, So as a business owner, you

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Speaker 2: would have to pay for your employees to carry out

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Speaker 2: that work, but then the business loses money as a result.

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Speaker 1: You can charge a co payment though, right the co.

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Speaker 2: Payment is only what the patient pays when they come

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Speaker 2: and see you for their appointment. So four and a

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Speaker 2: half hours of seeing patients generates about three and a

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Speaker 2: half hours of non patient facing time that's not paid

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Speaker 2: and certainly isn't covered by the money the funding you

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Speaker 2: get from the.

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Speaker 1: Consultation, So the co payment. So what I pay when

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Speaker 1: I go plus what the government pays you. You're saying,

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Speaker 1: would I only cover the four and a half hours

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Speaker 1: patient time, not the three and a half extra roughly?

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Speaker 2: Yes, yeah, I'd probably say that the funding doesn't even

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Speaker 2: cover the four and a half hours of the patient

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Speaker 2: facing time either. Right?

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Speaker 1: Is that because all the doctors are creaming it?

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Speaker 2: Oh? No, I think you talk to any GP and

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Speaker 2: I would hope you would know that that's not the case.

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Speaker 2: It's really sad that because our funding has not been

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Speaker 2: looked at and addressed for so long that GP many

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Speaker 2: GP practices have had no choice but to increase the

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Speaker 2: co payment that they charge patients. It's not something they want.

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Speaker 2: We want to provide an accessible service and we want

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Speaker 2: our patients to be able to come and see us

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Speaker 2: when they need to and to be able to afford

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Speaker 2: to do so what's.

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Speaker 1: The net effective that if you're in an area where

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Speaker 1: you can push up your co payment without cutting your

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Speaker 1: nose off to spite your fight, So now I'm going

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Speaker 1: to afford to come and see you anymore. Does that

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Speaker 1: mean that you will have a better service if you

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Speaker 1: are rich and living in a night well to do

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Speaker 1: area as opposed to if you were in a poorer area.

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Speaker 2: Yes, Unfortunately that is the case because with the way

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Speaker 2: funding works as inequity in the system, if you are

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Speaker 2: looking after a predominantly high needs population who are poorer you,

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Speaker 2: often they'll have they a community services card which makes

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Speaker 2: it cheaper for the patient to access to see you,

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Speaker 2: and you get a little bit more funding, but it's

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Speaker 2: certainly not enough to cover the costs of looking after them.

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Speaker 2: Whereas if you've got patients who are from a more

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Speaker 2: predominantly wealthy area, you can charge a bit more from

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Speaker 2: your co payment which helps cover your cost, but it's

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Speaker 2: still really at the moment, not enough to give you

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Speaker 2: an idea. And when I was trying to do write

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Speaker 2: this report, I was trying to find evidence to show

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Speaker 2: how much of our health budget goes on primary care,

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Speaker 2: and I couldn't easily find that data. But earlier or

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Speaker 2: last week study from Victoria University showed quite clearly that

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Speaker 2: for the last twenty years we have had an average

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Speaker 2: of five point four percent of the health budget spent

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Speaker 2: on primary care. And when you compare that to other

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Speaker 2: OECD countries, the ones that are doing well are spending

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Speaker 2: around fourteen percent.

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Speaker 1: So that's going to cost billions of dollars.

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Speaker 2: No, And what it means is, you know, we know

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Speaker 2: that you know, government is trying to reduce spending and

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Speaker 2: keep to budgets. What we would be asking for is

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Speaker 2: just a small repurportion of some of the health budget

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Speaker 2: into primary care. If we can't find new money, it's

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Speaker 2: just reassigning some of that to primary care. And one

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Speaker 2: of the ways is to look at the amount of

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Speaker 2: money you would save from preventing people turning up to

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Speaker 2: ED for instance.

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Speaker 1: He just one final thing, because this has been a

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Speaker 1: fascinating insight. A lot of what I've read today talks

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Speaker 1: about complex, increasingly complex needs and complicated patient situations. Is

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Speaker 1: this code for obesity problems related problems what is it

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Speaker 1: getting it?

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Speaker 2: Oh, there's any problem you can name.

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Speaker 1: Really we are Why have we got so many more problems?

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Speaker 2: I think, Well, one of the things is we've got

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Speaker 2: an aging population. By twenty twenty eight, we're going to

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Speaker 2: have over a million people aged over sixty five in

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Speaker 2: New Zealand. So that in itself, as you get older, unfortunately,

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Speaker 2: you're more likely to develop a chronic health condition and

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Speaker 2: or will be living with a disability. So there's that.

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Speaker 2: But we are also dealing with increased diabetes, that's for sure.

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Speaker 2: There's increasing mental health issues, which you've possibly talked about

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Speaker 2: at some point as well. But I think why these

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Speaker 2: issues are getting worse is because people aren't being able

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Speaker 2: to get in to see their usual doctor for them

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Speaker 2: to be able to pick up things early and help

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Speaker 2: support people to turn their health around.

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Speaker 1: It's a vicious circle. Doctor Probani would gp in New

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Speaker 1: Zealand Initiative Research Fellow, really enjoy talking to you. Thanks

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Speaker 1: so much for your time. Thank you for more from

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Speaker 1: Hither Duplessy Alan Drive. Listen live to news talks it'd

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