WEBVTT - Angus Chambers: "GPs know about long wait times more than anyone" 0:00:05.721 --> 0:00:09.681 You're listening to the Weekend Collective podcast from News Talks B. 0:00:10.041 --> 0:00:12.121 The government wants to add GP weight times to the 0:00:12.121 --> 0:00:15.721 list of healthcare targets. So we've had health had healthcare 0:00:15.961 --> 0:00:19.961 weight targets for a while now with emergency rooms specialist 0:00:20.041 --> 0:00:21.881 selective treatments, and it doesn't seem to have made a 0:00:21.921 --> 0:00:24.401 hell of a lot of difference. Health Minister Simeon Brown. 0:00:24.441 --> 0:00:26.881 He's at the ground running, isn't he. He says there 0:00:26.881 --> 0:00:28.761 are far too many people waiting more than a week 0:00:28.761 --> 0:00:30.881 to get a doctor's appointment and this could change that. 0:00:31.001 --> 0:00:34.481 And the jen pro that is the General. 0:00:34.121 --> 0:00:40.321 Proactive Owners Association chair Angus Chambers is with us, and 0:00:40.361 --> 0:00:41.601 I think he's with us. 0:00:42.081 --> 0:00:44.001 No, Hello, how you go? 0:00:44.481 --> 0:00:47.441 Sorry, just had a couple of technical issues distract me 0:00:47.441 --> 0:00:48.521 in the background there. 0:00:48.921 --> 0:00:51.521 That's okay. I can comment on environmental issues too, you know. 0:00:53.561 --> 0:00:59.921 Hey, well you stay on the line afterwards. What do 0:01:00.041 --> 0:01:02.241 you guys? How do you feel about targets? Do they 0:01:02.281 --> 0:01:03.041 really do anything? 0:01:05.361 --> 0:01:07.841 I have seen targets work to a degree. 0:01:08.121 --> 0:01:10.561 I think there's always a concern with targets that they 0:01:10.601 --> 0:01:13.921 create perverse incentives and you design your behavior and a. 0:01:13.881 --> 0:01:15.841 Target and sometimes miss other targets. 0:01:15.881 --> 0:01:18.521 But look, when we had an immunization target quite a 0:01:18.561 --> 0:01:23.001 long time ago, general practice got very well up towards 0:01:23.041 --> 0:01:26.481 the target because of focus on it. So, yeah, there's 0:01:26.481 --> 0:01:27.361 an argument for them. 0:01:27.441 --> 0:01:29.481 What's the incentive? And this is just a number in 0:01:29.481 --> 0:01:31.481 front of you. It's like having a pacemaker and a race, 0:01:31.561 --> 0:01:33.281 is it. You've got someone running at a certain speed 0:01:33.321 --> 0:01:34.401 in front of you and you're like, we got to 0:01:34.441 --> 0:01:34.921 keep up with this. 0:01:36.081 --> 0:01:37.121 Look, there's a little bit of that. 0:01:37.161 --> 0:01:40.841 I mean, you know, sometimes incentives have a financial part 0:01:40.841 --> 0:01:43.801 of it, So look, you know that's that's always helpful. 0:01:44.201 --> 0:01:48.321 I think there's an element of competition, and people don't 0:01:48.401 --> 0:01:51.361 like being lower down in a league table a personal 0:01:51.401 --> 0:01:53.681 pride thing, so that can sort of have some effect 0:01:53.681 --> 0:01:54.041 as well. 0:01:54.481 --> 0:01:55.441 So how is it going to work? 0:01:55.441 --> 0:01:58.321 Are you going to see is each practice going to 0:01:58.361 --> 0:02:00.561 sort of see how it sits with others? Is it 0:02:00.601 --> 0:02:02.481 some sort of thing where there's like a ladder that's 0:02:02.481 --> 0:02:04.521 sitting in front of everyone and these guys are winning, 0:02:04.521 --> 0:02:05.401 these guys losing. 0:02:06.921 --> 0:02:09.601 Look, actually, we have no idea how it's going to 0:02:09.641 --> 0:02:12.921 be constructed, and we'd really like to be part of 0:02:12.921 --> 0:02:16.441 that because we know the situation in our business better 0:02:16.481 --> 0:02:18.481 than anybody else. I mean, you know, the Ministry of 0:02:18.521 --> 0:02:21.681 Health has really got very few clues around the delivery 0:02:21.681 --> 0:02:23.761 of general practice care. So the number one thing for 0:02:23.881 --> 0:02:26.641 us is to actually, let's work together. You want to 0:02:26.681 --> 0:02:29.281 achieve better weight times. Actually we want to achieve better 0:02:29.281 --> 0:02:31.281 weight times too, But there are ways. 0:02:31.041 --> 0:02:32.281 Of doing it, in ways of not doing it. 0:02:32.321 --> 0:02:34.081 So yeah, look, we don't know what the targets will be, 0:02:34.841 --> 0:02:38.281 but there's certainly a risk that it will shift behavior 0:02:38.321 --> 0:02:41.241 in a way that doesn't give the outcome people want. 0:02:41.241 --> 0:02:44.601 Sometimes and what's an example of that, what couldn't we solve? 0:02:44.601 --> 0:02:47.681 Would that be rushed rush service sort of thing, not 0:02:47.721 --> 0:02:50.121 giving people the right time they want the wrong diagnosis, 0:02:50.121 --> 0:02:51.521 that sort of thing, A. 0:02:51.481 --> 0:02:52.081 Little bit of that. 0:02:52.121 --> 0:02:55.401 But look, let's say you've got books closed because you 0:02:55.641 --> 0:02:58.441 just cannot meet the demands of the patience you've got already, 0:02:58.481 --> 0:02:59.921 and so it's an ethical thing to do to close 0:02:59.961 --> 0:03:01.521 your box and just look after the people you've made 0:03:01.521 --> 0:03:03.521 a promise to work after. If you're going to get 0:03:03.521 --> 0:03:07.081 more bunny to have open books at capacity already. If 0:03:07.081 --> 0:03:09.201 you open your books, you'll add more patients, there'll be 0:03:09.201 --> 0:03:11.201 more work to do, and wait times will grow so 0:03:11.721 --> 0:03:13.081 you know, you can see it working that way. 0:03:14.001 --> 0:03:14.881 I think the. 0:03:14.881 --> 0:03:18.641 Chances of people being unethical to cram more people in 0:03:19.761 --> 0:03:22.001 less high, although there is a risk of that, but 0:03:22.161 --> 0:03:24.241 you know, you want to do a good job and 0:03:24.281 --> 0:03:28.081 we have got ethics that dictate that you actually operate 0:03:28.121 --> 0:03:28.881 in a certain way. 0:03:29.001 --> 0:03:30.961 So yeah, I think you said that. 0:03:31.001 --> 0:03:32.681 You made a comment about we'd like to be part 0:03:32.721 --> 0:03:35.961 of it. It sounded like I got the impression you 0:03:36.001 --> 0:03:38.081 haven't been consulted about this. This is something you've read 0:03:38.121 --> 0:03:39.881 in the headlines, and it's like, oh, well, that's that's 0:03:39.881 --> 0:03:40.521 interesting to hear. 0:03:40.961 --> 0:03:41.961 It's news to us. 0:03:42.521 --> 0:03:44.881 One hundred percent. You know, no, they no involvement with the 0:03:45.321 --> 0:03:48.921 sect or whatever. There's quite a catch cry in patient 0:03:49.081 --> 0:03:51.441 care delivery is nothing about us without us, but it 0:03:51.481 --> 0:03:56.841 doesn't seem to apply to our service delivery models. But yeah, no, no, 0:03:56.881 --> 0:03:59.641 we haven't been consulted at all. We've been advocating for 0:03:59.721 --> 0:04:04.201 the increased funding that's come in, but you know it 0:04:04.281 --> 0:04:07.721 could be forcial in the way it's it's incentivized if 0:04:07.761 --> 0:04:08.041 it is in. 0:04:08.721 --> 0:04:11.641 Actually, just can I dig into that a bit, because 0:04:11.641 --> 0:04:13.681 if I was a GP or as in your position 0:04:13.761 --> 0:04:17.761 as a major organization, I mean the General Practice Owners Association. 0:04:18.721 --> 0:04:21.401 I would feel pretty blim and annoyed that you read 0:04:21.441 --> 0:04:23.361 an announcement that there's going to be targets set to 0:04:23.401 --> 0:04:26.241 you when no one's spoken to you about. 0:04:26.041 --> 0:04:30.561 Its welcome red. Yeah. 0:04:30.641 --> 0:04:35.001 Look, I mean, perhaps I shouldn't be too outrageous, but 0:04:35.081 --> 0:04:36.921 you know, we hear over and over again that there's 0:04:36.961 --> 0:04:40.401 a very deep suspicion and even enmity towards general practice 0:04:40.441 --> 0:04:43.561 within the Ministry of Health, and you know, maybe that's true, 0:04:43.561 --> 0:04:44.041 maybe it's not. 0:04:44.161 --> 0:04:46.161 We've had some very well connected people say. 0:04:46.041 --> 0:04:49.241 It, and yeah, I think it's that rageous because not 0:04:49.361 --> 0:04:54.241 only is there that kind of you know, disappointment that 0:04:54.241 --> 0:04:56.281 we're not there, but we actually know it better than 0:04:56.281 --> 0:04:59.361 anybody else, and we feel like if we were able 0:04:59.401 --> 0:05:02.321 to contribute, we'd have a better outcome for all concerned, 0:05:02.321 --> 0:05:05.401 both the doctor's patients and the people who who want 0:05:05.401 --> 0:05:06.601 to see their policy succeed. 0:05:07.081 --> 0:05:08.921 So what do you understand the announcement is? 0:05:08.921 --> 0:05:10.081 So I'm going to need to dig into it a 0:05:10.121 --> 0:05:11.961 bit more because it's just, you know, I just assume 0:05:12.001 --> 0:05:14.281 you'd be all over this because the Ministry had consulted 0:05:14.281 --> 0:05:17.681 you with it, So all you know so far is 0:05:17.721 --> 0:05:20.601 that the government government wants to add targets for GP 0:05:20.761 --> 0:05:24.041 wait times and beyond that, you're none the wiser. 0:05:25.081 --> 0:05:27.201 Well, let's look at the things we do know. 0:05:27.321 --> 0:05:30.081 Is there's ninety five million dollars that has been dedicated 0:05:30.121 --> 0:05:33.041 to increasing what they call capitation's fees you get for 0:05:33.081 --> 0:05:38.601 looking after patients from the state. And then there's been 0:05:38.681 --> 0:05:41.681 it's been talked about that there'll be incentives to improve 0:05:41.721 --> 0:05:45.561 the access and the minister did mention open books. I 0:05:45.601 --> 0:05:49.361 have spoken to an official more since since he said that. 0:05:49.401 --> 0:05:51.801 He said, actually he doesn't think it's going to operate 0:05:52.001 --> 0:05:54.001 like that, but you know, you have to rely on 0:05:54.041 --> 0:05:57.121 the minister's words. So look, that's all we know about 0:05:57.121 --> 0:05:59.921 this funding, that the actual dollar figure, and that there 0:05:59.961 --> 0:06:03.561 will be some kind of incentivization to try and to 0:06:03.721 --> 0:06:06.601 achieve and I think it was wait times of immunization 0:06:06.801 --> 0:06:07.641 was mentioned as well. 0:06:08.601 --> 0:06:09.961 But yeah, so those kind of things. 0:06:10.281 --> 0:06:15.361 So in reality, in terms of getting us moving along 0:06:15.361 --> 0:06:17.561 and people not having to wait so long for a 0:06:17.601 --> 0:06:20.961 GP appointment, what are the things you would really like 0:06:21.041 --> 0:06:21.441 to see? 0:06:23.721 --> 0:06:28.961 Well, look, actually, all hinges on workforce and if you 0:06:29.201 --> 0:06:32.681 don't have enough staff to deliver service and you can't 0:06:32.721 --> 0:06:35.801 get them, you're behind it from the very beginning. And look, 0:06:35.801 --> 0:06:38.601 this is this is a problem of decades in the making. 0:06:38.841 --> 0:06:41.041 You know, all of the demographics of the general practice 0:06:41.041 --> 0:06:43.241 workforce and all the analysis said that we're going to 0:06:43.281 --> 0:06:45.681 reach this sort of shortage time around about now because 0:06:45.681 --> 0:06:50.281 there's so many people retiring. It's been compounded by somewhat 0:06:50.321 --> 0:06:53.961 unattractive terms and conditions nowadays compared with doctors. What doctors 0:06:53.961 --> 0:06:56.641 can get elsewhere and nurses, I might say, so whether 0:06:56.681 --> 0:06:59.641 it's in the secondary care hospital systems or Australia of course. 0:06:59.681 --> 0:07:02.561 So look, this has been taking years of it it's 0:07:02.601 --> 0:07:05.641 making Actually it's going to take a while to turn around. Okay, 0:07:05.641 --> 0:07:07.801 they're going to be training more doctors, but you know 0:07:07.881 --> 0:07:11.241 that's probably twelve years before they're you know, even got 0:07:11.921 --> 0:07:16.361 their qualifica full qualification for general practice. We we you know, 0:07:16.401 --> 0:07:18.841 the first thing we need to do is stop people leaving, 0:07:18.881 --> 0:07:21.721 and they are leaving. And that's so it comes back 0:07:21.761 --> 0:07:25.601 to funding, because if you can't offer an attractive proposition, 0:07:26.121 --> 0:07:28.641 people will go elsewhere or vote with their and work 0:07:28.681 --> 0:07:32.321 vote with their feet. So yeah, that's it's workforce, workforce, workforce. 0:07:32.401 --> 0:07:36.241 And they've made some announcements to help improve the workforce, 0:07:36.241 --> 0:07:36.961 but again, that's. 0:07:36.841 --> 0:07:39.481 Going to take a long time before it comes into effect. 0:07:39.521 --> 0:07:43.521 Where we kind of employer doctors, well we can employ them, 0:07:43.561 --> 0:07:47.561 we can't find them to employ right now. And this 0:07:47.641 --> 0:07:49.921 money will help, but it's not going to fix it soon. 0:07:49.961 --> 0:07:53.721 And there's alternative work workforces that are coming through, and look, 0:07:53.801 --> 0:07:55.081 you know we use a lot of that at our 0:07:55.121 --> 0:07:55.841 practice already. 0:07:55.881 --> 0:07:58.201 But it's a hard talk with either are you're. 0:07:58.081 --> 0:08:00.721 Talking about the overseas doctor qualification the way that they 0:08:00.721 --> 0:08:04.921 can get certified more efficiently, I guess or quickly in nurse. 0:08:04.801 --> 0:08:08.241 Per Yeah, that's one of them. Nurse practitioner training. There's 0:08:08.961 --> 0:08:12.001 a group call physicians Associates and look, and there's quite 0:08:12.041 --> 0:08:14.121 a lot of dispute around all this stuff, and there 0:08:14.201 --> 0:08:16.641 is certainly some evidence that they'll actually cost the system 0:08:16.721 --> 0:08:20.641 more because there order more tests, refer more people into 0:08:20.521 --> 0:08:22.961 the secondary care, which is vastly more expensive than dealing 0:08:23.001 --> 0:08:25.081 with them efficiently and effectively in the community. 0:08:25.201 --> 0:08:26.801 So would it be fair for me to say, great, 0:08:27.121 --> 0:08:29.481 we love the announcement. It's good to try and do something, 0:08:29.481 --> 0:08:31.401 but a little more consultation wouldn't hurt. 0:08:32.801 --> 0:08:36.201 Yeah, Look, it's definitely a good start. It's hard to begrudge. 0:08:36.561 --> 0:08:39.361 You know, we're getting extra funding when you know a 0:08:39.401 --> 0:08:41.161 lot of people are having cuts. 0:08:40.561 --> 0:08:42.481 So it's a good start. 0:08:42.681 --> 0:08:45.121 We think, cork with us and we'll actually make the 0:08:45.161 --> 0:08:47.961 money work better. And yeah, in the future, we'd really 0:08:48.081 --> 0:08:51.801 like to have a bit more input around the design 0:08:51.801 --> 0:08:54.441 of the system because we know better than anybody else 0:08:54.521 --> 0:08:55.121 how it works. 0:08:55.401 --> 0:08:56.081 Oh, good stuff. 0:08:56.641 --> 0:08:59.081 Obviously, if you're a part of the General Practice Association, 0:08:59.121 --> 0:09:00.801 you've got your own practice, how are you coping in 0:09:01.401 --> 0:09:02.081 your practice? 0:09:04.201 --> 0:09:07.801 Look, it's abs and downs, it's quite it's quite hard work. 0:09:07.841 --> 0:09:09.921 I mean, there's a lot other things to say about 0:09:09.961 --> 0:09:12.321 the extra demands that have come through the General Practice 0:09:12.841 --> 0:09:15.201 over the last you know, the end of twenty years. 0:09:15.241 --> 0:09:17.921 But you know, it's really unfortunate for us. We've just 0:09:18.041 --> 0:09:22.481 had three doctors indicate that they're going to be moving on, 0:09:22.601 --> 0:09:24.801 and they're all quite legitimate reasons. 0:09:25.241 --> 0:09:28.361 That Australia Australia, Australia. 0:09:29.121 --> 0:09:31.761 Oh look, one has a spouse who's got his own 0:09:31.801 --> 0:09:34.281 practice and that she's probably gonna move there, and you know, 0:09:35.441 --> 0:09:37.081 we have lost them to Australia before. 0:09:37.121 --> 0:09:39.081 But none of these particular ones are going to Australia. 0:09:39.161 --> 0:09:42.161 Oh, I really appreciate your time on the staffening and angus. 0:09:42.201 --> 0:09:45.841 You can't stick around and comment that on Chris Pink's announcement. 0:09:47.361 --> 0:09:49.641 You'd have to brief me a little bit first, but yeah. 0:09:50.681 --> 0:09:52.601 Hey, thanks very much. I thanks, really appreciate it. 0:09:53.121 --> 0:09:55.881 For more from the Weekend Collective, listen live to News 0:09:55.921 --> 0:09:59.041 Talks it'd be weekends from three pm, or follow the 0:09:59.041 --> 0:10:00.601 podcast on iHeartRadio.