Speaker 1: You're listening to the Weekend Collective podcast from News Talks B.
Speaker 2: The government wants to add GP weight times to the
Speaker 2: list of healthcare targets. So we've had health had healthcare
Speaker 2: weight targets for a while now with emergency rooms specialist
Speaker 2: selective treatments, and it doesn't seem to have made a
Speaker 2: hell of a lot of difference. Health Minister Simeon Brown.
Speaker 2: He's at the ground running, isn't he. He says there
Speaker 2: are far too many people waiting more than a week
Speaker 2: to get a doctor's appointment and this could change that.
Speaker 3: And the jen pro that is the General.
Speaker 2: Proactive Owners Association chair Angus Chambers is with us, and
Speaker 2: I think he's with us.
Speaker 4: No, Hello, how you go?
Speaker 2: Sorry, just had a couple of technical issues distract me
Speaker 2: in the background there.
Speaker 4: That's okay. I can comment on environmental issues too, you know.
Speaker 3: Hey, well you stay on the line afterwards. What do
Speaker 3: you guys? How do you feel about targets? Do they
Speaker 3: really do anything?
Speaker 4: I have seen targets work to a degree.
Speaker 5: I think there's always a concern with targets that they
Speaker 5: create perverse incentives and you design your behavior and a.
Speaker 4: Target and sometimes miss other targets.
Speaker 5: But look, when we had an immunization target quite a
Speaker 5: long time ago, general practice got very well up towards
Speaker 5: the target because of focus on it. So, yeah, there's
Speaker 5: an argument for them.
Speaker 2: What's the incentive? And this is just a number in
Speaker 2: front of you. It's like having a pacemaker and a race,
Speaker 2: is it. You've got someone running at a certain speed
Speaker 2: in front of you and you're like, we got to
Speaker 2: keep up with this.
Speaker 4: Look, there's a little bit of that.
Speaker 5: I mean, you know, sometimes incentives have a financial part
Speaker 5: of it, So look, you know that's that's always helpful.
Speaker 5: I think there's an element of competition, and people don't
Speaker 5: like being lower down in a league table a personal
Speaker 5: pride thing, so that can sort of have some effect
Speaker 5: as well.
Speaker 3: So how is it going to work?
Speaker 2: Are you going to see is each practice going to
Speaker 2: sort of see how it sits with others? Is it
Speaker 2: some sort of thing where there's like a ladder that's
Speaker 2: sitting in front of everyone and these guys are winning,
Speaker 2: these guys losing.
Speaker 5: Look, actually, we have no idea how it's going to
Speaker 5: be constructed, and we'd really like to be part of
Speaker 5: that because we know the situation in our business better
Speaker 5: than anybody else. I mean, you know, the Ministry of
Speaker 5: Health has really got very few clues around the delivery
Speaker 5: of general practice care. So the number one thing for
Speaker 5: us is to actually, let's work together. You want to
Speaker 5: achieve better weight times. Actually we want to achieve better
Speaker 5: weight times too, But there are ways.
Speaker 4: Of doing it, in ways of not doing it.
Speaker 5: So yeah, look, we don't know what the targets will be,
Speaker 5: but there's certainly a risk that it will shift behavior
Speaker 5: in a way that doesn't give the outcome people want.
Speaker 3: Sometimes and what's an example of that, what couldn't we solve?
Speaker 2: Would that be rushed rush service sort of thing, not
Speaker 2: giving people the right time they want the wrong diagnosis,
Speaker 2: that sort of thing, A.
Speaker 4: Little bit of that.
Speaker 5: But look, let's say you've got books closed because you
Speaker 5: just cannot meet the demands of the patience you've got already,
Speaker 5: and so it's an ethical thing to do to close
Speaker 5: your box and just look after the people you've made
Speaker 5: a promise to work after. If you're going to get
Speaker 5: more bunny to have open books at capacity already. If
Speaker 5: you open your books, you'll add more patients, there'll be
Speaker 5: more work to do, and wait times will grow so
Speaker 5: you know, you can see it working that way.
Speaker 4: I think the.
Speaker 5: Chances of people being unethical to cram more people in
Speaker 5: less high, although there is a risk of that, but
Speaker 5: you know, you want to do a good job and
Speaker 5: we have got ethics that dictate that you actually operate
Speaker 5: in a certain way.
Speaker 4: So yeah, I think you said that.
Speaker 2: You made a comment about we'd like to be part
Speaker 2: of it. It sounded like I got the impression you
Speaker 2: haven't been consulted about this. This is something you've read
Speaker 2: in the headlines, and it's like, oh, well, that's that's
Speaker 2: interesting to hear.
Speaker 3: It's news to us.
Speaker 5: One hundred percent. You know, no, they no involvement with the
Speaker 5: sect or whatever. There's quite a catch cry in patient
Speaker 5: care delivery is nothing about us without us, but it
Speaker 5: doesn't seem to apply to our service delivery models. But yeah, no, no,
Speaker 5: we haven't been consulted at all. We've been advocating for
Speaker 5: the increased funding that's come in, but you know it
Speaker 5: could be forcial in the way it's it's incentivized if
Speaker 5: it is in.
Speaker 2: Actually, just can I dig into that a bit, because
Speaker 2: if I was a GP or as in your position
Speaker 2: as a major organization, I mean the General Practice Owners Association.
Speaker 2: I would feel pretty blim and annoyed that you read
Speaker 2: an announcement that there's going to be targets set to
Speaker 2: you when no one's spoken to you about.
Speaker 4: Its welcome red. Yeah.
Speaker 5: Look, I mean, perhaps I shouldn't be too outrageous, but
Speaker 5: you know, we hear over and over again that there's
Speaker 5: a very deep suspicion and even enmity towards general practice
Speaker 5: within the Ministry of Health, and you know, maybe that's true,
Speaker 5: maybe it's not.
Speaker 4: We've had some very well connected people say.
Speaker 5: It, and yeah, I think it's that rageous because not
Speaker 5: only is there that kind of you know, disappointment that
Speaker 5: we're not there, but we actually know it better than
Speaker 5: anybody else, and we feel like if we were able
Speaker 5: to contribute, we'd have a better outcome for all concerned,
Speaker 5: both the doctor's patients and the people who who want
Speaker 5: to see their policy succeed.
Speaker 3: So what do you understand the announcement is?
Speaker 2: So I'm going to need to dig into it a
Speaker 2: bit more because it's just, you know, I just assume
Speaker 2: you'd be all over this because the Ministry had consulted
Speaker 2: you with it, So all you know so far is
Speaker 2: that the government government wants to add targets for GP
Speaker 2: wait times and beyond that, you're none the wiser.
Speaker 4: Well, let's look at the things we do know.
Speaker 5: Is there's ninety five million dollars that has been dedicated
Speaker 5: to increasing what they call capitation's fees you get for
Speaker 5: looking after patients from the state. And then there's been
Speaker 5: it's been talked about that there'll be incentives to improve
Speaker 5: the access and the minister did mention open books. I
Speaker 5: have spoken to an official more since since he said that.
Speaker 5: He said, actually he doesn't think it's going to operate
Speaker 5: like that, but you know, you have to rely on
Speaker 5: the minister's words. So look, that's all we know about
Speaker 5: this funding, that the actual dollar figure, and that there
Speaker 5: will be some kind of incentivization to try and to
Speaker 5: achieve and I think it was wait times of immunization
Speaker 5: was mentioned as well.
Speaker 4: But yeah, so those kind of things.
Speaker 2: So in reality, in terms of getting us moving along
Speaker 2: and people not having to wait so long for a
Speaker 2: GP appointment, what are the things you would really like
Speaker 2: to see?
Speaker 5: Well, look, actually, all hinges on workforce and if you
Speaker 5: don't have enough staff to deliver service and you can't
Speaker 5: get them, you're behind it from the very beginning. And look,
Speaker 5: this is this is a problem of decades in the making.
Speaker 5: You know, all of the demographics of the general practice
Speaker 5: workforce and all the analysis said that we're going to
Speaker 5: reach this sort of shortage time around about now because
Speaker 5: there's so many people retiring. It's been compounded by somewhat
Speaker 5: unattractive terms and conditions nowadays compared with doctors. What doctors
Speaker 5: can get elsewhere and nurses, I might say, so whether
Speaker 5: it's in the secondary care hospital systems or Australia of course.
Speaker 5: So look, this has been taking years of it it's
Speaker 5: making Actually it's going to take a while to turn around. Okay,
Speaker 5: they're going to be training more doctors, but you know
Speaker 5: that's probably twelve years before they're you know, even got
Speaker 5: their qualifica full qualification for general practice. We we you know,
Speaker 5: the first thing we need to do is stop people leaving,
Speaker 5: and they are leaving. And that's so it comes back
Speaker 5: to funding, because if you can't offer an attractive proposition,
Speaker 5: people will go elsewhere or vote with their and work
Speaker 5: vote with their feet. So yeah, that's it's workforce, workforce, workforce.
Speaker 5: And they've made some announcements to help improve the workforce,
Speaker 5: but again, that's.
Speaker 4: Going to take a long time before it comes into effect.
Speaker 5: Where we kind of employer doctors, well we can employ them,
Speaker 5: we can't find them to employ right now. And this
Speaker 5: money will help, but it's not going to fix it soon.
Speaker 5: And there's alternative work workforces that are coming through, and look,
Speaker 5: you know we use a lot of that at our
Speaker 5: practice already.
Speaker 4: But it's a hard talk with either are you're.
Speaker 2: Talking about the overseas doctor qualification the way that they
Speaker 2: can get certified more efficiently, I guess or quickly in nurse.
Speaker 5: Per Yeah, that's one of them. Nurse practitioner training. There's
Speaker 5: a group call physicians Associates and look, and there's quite
Speaker 5: a lot of dispute around all this stuff, and there
Speaker 5: is certainly some evidence that they'll actually cost the system
Speaker 5: more because there order more tests, refer more people into
Speaker 5: the secondary care, which is vastly more expensive than dealing
Speaker 5: with them efficiently and effectively in the community.
Speaker 2: So would it be fair for me to say, great,
Speaker 2: we love the announcement. It's good to try and do something,
Speaker 2: but a little more consultation wouldn't hurt.
Speaker 4: Yeah, Look, it's definitely a good start. It's hard to begrudge.
Speaker 5: You know, we're getting extra funding when you know a
Speaker 5: lot of people are having cuts.
Speaker 4: So it's a good start.
Speaker 5: We think, cork with us and we'll actually make the
Speaker 5: money work better. And yeah, in the future, we'd really
Speaker 5: like to have a bit more input around the design
Speaker 5: of the system because we know better than anybody else
Speaker 5: how it works.
Speaker 3: Oh, good stuff.
Speaker 2: Obviously, if you're a part of the General Practice Association,
Speaker 2: you've got your own practice, how are you coping in
Speaker 2: your practice?
Speaker 5: Look, it's abs and downs, it's quite it's quite hard work.
Speaker 5: I mean, there's a lot other things to say about
Speaker 5: the extra demands that have come through the General Practice
Speaker 5: over the last you know, the end of twenty years.
Speaker 5: But you know, it's really unfortunate for us. We've just
Speaker 5: had three doctors indicate that they're going to be moving on,
Speaker 5: and they're all quite legitimate reasons.
Speaker 2: That Australia Australia, Australia.
Speaker 5: Oh look, one has a spouse who's got his own
Speaker 5: practice and that she's probably gonna move there, and you know,
Speaker 5: we have lost them to Australia before.
Speaker 4: But none of these particular ones are going to Australia.
Speaker 2: Oh, I really appreciate your time on the staffening and angus.
Speaker 2: You can't stick around and comment that on Chris Pink's announcement.
Speaker 4: You'd have to brief me a little bit first, but yeah.
Speaker 3: Hey, thanks very much. I thanks, really appreciate it.
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