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Speaker 1: More evidence this morning than our public health system not

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Speaker 1: cranking all that well. Study out of the University of

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Speaker 1: Targo found specialist cares becoming harder to access, specialist declining

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Speaker 1: more referrals from GPS risk of being declined has risen

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Speaker 1: more than five percent a year between twenty eighteen and

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Speaker 1: twenty twenty two. General Practice New Zealand commission this research.

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Speaker 1: The Chairers doctor Brian Betty is well, it's Brian, very

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Speaker 1: good morning to you by Mike. Just confirmed for me,

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Speaker 1: because I've had mixed reports. Is it five percent a

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Speaker 1: year over those four years or five percent over those

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Speaker 1: four years?

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Speaker 2: It seems to be five percent over those four years,

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Speaker 2: but it's six hundred thousand referred to specialist service a year,

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Speaker 2: so that's about eighty five thousand per year at this point.

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Speaker 2: So it's large, large numbers.

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Speaker 1: So when yeah, it's large numbers, but in percentage, five

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Speaker 1: percent over of four years is one point something percent

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Speaker 1: per year. And although if you're on the list know

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Speaker 1: AND's happy about it, of course, but is that is

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Speaker 1: that material per se and is there something going on

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Speaker 1: or is that just sort of statistical variation?

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Speaker 2: No, No, it's statistically very relevant. So So the thing

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Speaker 2: about is that the referral have stayed static over that

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Speaker 2: four years at six hundred thousand, So yeah, that increase

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Speaker 2: is about seventeen thousand referrals declined per year, so that

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Speaker 2: is actually really really relevant. So yeah, these are big numbers.

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Speaker 1: And why do they Is it the money? We can't

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Speaker 1: do it, or I've had a look at your case

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Speaker 1: and the GP got a bit over anxious here and

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Speaker 1: I don't need to see you.

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Speaker 2: No, no, I certainly not. If you go back, we

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Speaker 2: had less declines exactly the same number of ferals. GPS

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Speaker 2: refer patients for a reason. There's a reason for doing it.

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Speaker 2: They do their job, they decide they need a specialist

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Speaker 2: to have some input. There's a reason for doing it.

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Speaker 2: So GPS aren't just making this up. So no, what

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Speaker 2: seems to be happening is the threshold seem to be changing.

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Speaker 2: That is, the bar to get in to see a

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Speaker 2: specialist seems to be getting higher. And that's based on

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Speaker 2: the fact that there's not enough capacity in the hospital

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Speaker 2: system to see these patients.

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Speaker 1: So they would tell me if I asked them, I'd say, yep,

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Speaker 1: I would see you if I could. But given I'm stuck,

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Speaker 1: don't have the staff, where I don't have the budget, I.

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Speaker 2: Can't Oh, there's been a number of cases this happens

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Speaker 2: in orthopedics and we've seen this in Wellington, and I've

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Speaker 2: seen this with patients of mind where they've actually got

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Speaker 2: to see the specialist and the specialists said yes, you

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Speaker 2: need an operation. Then the hospital has actually declined the operation,

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Speaker 2: said no, we're sending you back to the GP because

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Speaker 2: we do not have capacity to do the operation. So

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Speaker 2: the problem with this, Mike, is that everyone focuses on

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Speaker 2: the waiting list and how large the waiting list is.

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Speaker 2: We're not focused on the eighty five thousand a year

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Speaker 2: who are to be being declined and not even getting

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Speaker 2: onto the waiting list. And that's the hidden problem in

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Speaker 2: the system.

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Speaker 1: And that's once again the poor old GP. Because if

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Speaker 1: you've sent somebody off to do something and they can't

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Speaker 1: do it, what do you do? I mean, you know

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Speaker 1: you're start, can't you.

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Speaker 2: Well, well, well this is the problem. So that the

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Speaker 2: problem has been pushed back to the GP, they're left

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Speaker 2: it managing a patient who's got a problem that should

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Speaker 2: be seen in secondary care. They're saying they're often working

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Speaker 2: being forced to work sort of out of their scope.

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Speaker 2: They having to manage patients with increased pain medication and

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Speaker 2: for the patient, quality of life goes down. And we

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Speaker 2: know from the research they have to see the GP

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Speaker 2: more often. It's costing them more money, and it's just

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Speaker 2: a bad It's bad for the system, it's bad for

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Speaker 2: the GPS, it's bad for the patient.

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Speaker 1: That's thirty million on radiology from Shane Ready yesterday. Is

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Speaker 1: that the sort of thing that will alleviate it.

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Speaker 2: I think that's a real step in the right direction.

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Speaker 2: I'd have to sort of applaud the government for doing this.

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Speaker 2: I mean, look, gps need access to things like radiology

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Speaker 2: in the community to do their job. It's like like

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Speaker 2: a builder not having a power drill to build a house.

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Speaker 2: You can't do your job. This has been a problem

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Speaker 2: for years. We've been explaining to the government. This is

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Speaker 2: really problematic because the only other place we can send

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Speaker 2: a patient who cannot afford an X ray is to

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Speaker 2: the emergency department or to the hospital. It puts extra

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Speaker 2: pressure on the hospital, so we need to sort this

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Speaker 2: problem out. This is a really really positive step forward.

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Speaker 1: Good stuff, Bryan, you have a good weekend. Appreciate it.

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Speaker 1: Doctor Brian Betty, General Practice New Zealand Chair This Morning.

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