Meeting the Challenge – Kokiringia te Wero

This was the title of our latest Conference held in Rotorua so I thought it appropriate to report on the multitude of challenges presented to the College and general practice during those three action packed days.

My first challenge was connecting my body with my circadian rhythm as I arrived in Rotorua straight from a private trip to Europe. That journey sure does scramble the brain somewhat. One day when GP income is commensurate with our secondary care partialist colleagues maybe I can travel business class.

As usual College Council had a full day meeting prior to Conference. This meeting was notable for Council approving the new curriculum for the vocational education of General Practitioners; no small piece of work that College members and staff on the Pathway Working Party have worked for some time. The new curriculum is very important for all general practitioners to ensure we have the appropriate skills and knowledge base to provide optimum healthcare to patients in our diverse communities.

Council threw out some challenges. Major ones were to advance the Research Framework and the review of Aiming for Excellence. Faculties have charged us with a variety of issues to do with improving services to members and information flows. We have also challenged Faculties but more of that later.

So into the Conference and our speakers set about us. Gregor Coster wants greater IT connectivity between primary and secondary care. He also challenged delegates and new fellows to consider becoming GP teachers and to think about involvement in management and governance roles.

A magnificent Oration from self-styled dinosaur Dr Tony Townsend told of his journey through life and general practice [the two are intertwined as it is for so many of that generation]. He mourned the changing views of subsequent generations to what for us was a vocation and for some now is just a job.

A recurring event throughout the conference was the re-telling of the Darwinism that you have to adapt to survive. What killed the dinosaurs, however, is still open to debate although most accept it was a cataclysmic event rather than a turn of evolution. Dinosaurs were magnificent beasts and are not a bad role model. Remember they dominated the terrestrial ecosystem for 160 million years.

Our overseas speakers reminded us of the value of, and the economies within, primary care, and of triumphs and disasters in their health systems. All acknowledged how much New Zealand Primary Care does with so little and at such a high standard. We outperform most other countries even when they spend exponentially larger amounts of money on health.

A challenge that emerged time and again concerned our young GPs and GP registrars. After the roasting in the press from Dr Steve Child of Auckland DHB [his generation were selfless but the present one was selfish] it was good to hear that young GPs and GP registrars wanted to get involved in College matters. We need them and I shall make sure that each Faculty is sent a list of successful Primex candidates and works to involve them in Faculty events. The challenge I lay down for them is to look ahead five or 10 years and imagine what role they would like to play in the College; and how they will get there.

On the second day of the Conference the Clinical Training Agency confirmed funding to double the number of house surgeons undertaking rural general practice runs. An additional 26 places takes the total available to 50. Funding had already been agreed for the increase in GP registrar places to 104, announced by health minister Pete Hodgson last month. This is a challenge that we welcome. Tight recruitment timeframes and funding specifics yet to be finalised aside, growth in training numbers is good news for the profession. What we need now is GPs taking up the challenge to be educators.
docendo discmus, as Gregor Coster reminded us in the Fellowship address…
I teach, therefore I learn.

That evening we had the challenge of trying not to enjoy ourselves at the Conference Dinner so we could still function the next day. It was a glorious evening – James Bond themed. We now use the Conference dinner to present College awards. You will read elsewhere about the recipients but it was with great pleasure that I was able, on your behalf, to acknowledge those College members who have given so much to the profession.

On the last day of conference we had a stirring speech by Dr Pita Sharples. He laid down challenges as to how the GP can better support the health needs of Maori. Fortunately we immediately responded to this challenge with the release of the College’s document Cultural Competence: Advice for GPs to create and maintain culturally competent general practices in New Zealand.

Your College is acknowledged as a leader far out in front of other medical Colleges both in New Zealand and internationally for its work in aiming to improve the cultural competence of the primary care workforce. Until we get that right we are not going to reduce the health disparities that exist between various cultures here.

The combination of the College AGM and the Policy Forum was quite invigorating, The stimulating questions and discussion on five key topics within general practice was very lively, and will help direct us as we continue to work hard on your behalf.

My personal challenge from the Conference is to put into action all those good ideas I learnt about in the sessions and, more importantly, over coffee. We never stop learning and we never stop teaching.

See you in Queenstown next year.