Budget 2025 opinion: We don't need to create a new health service, we need to invest in the current one

Our health system is ready for a new chapter.

Across the sector we are seeing workforces stretched to capacity, long wait times and closed books. As health professionals it hurts to see patients not getting the care they need, when they need it.

To fix this, we need solutions that are cost-effective, sustainable, fair and patient-focused. We don’t need to create a different service. We need to invest in the current service and recognise the opportunity that lies within general practice for communities to thrive and be healthy.

We know healthcare starts and often ends in the community. We have 23 million patient contacts each year, far more than any other medical specialty. Our clinics are innovative offering rapidly evolving services and options for access, through a broad range of expert professions. Investing in primary care is the most cost-effective way to address the challenges in the sector.

Primary care teams across many other OECD countries receive on average around 14% of their overall health budgets (based on 2016 data). In New Zealand however, primary care receives on average less than 6% of the health budget.

If we can provide 23 million patient contacts per year on less than 6% funding from the health budget imagine what we could do if we had fair and fit–for-purpose funding. Imagine if we were in line with other OECD countries and primary care was funded for the work we do and the increasing patient need we’re seeing.

Evidence shows if you have the same GP for more than 15 years your mortality is reduced by 25%, hospital admissions are reduced by 28% and out of hours visits are reduced by 30%.

For every $1 spent in primary care, $14 is saved further down the line in secondary or hospital-based care. Our continuity of care enables us to pick up issues faster and ensure patients get the care they need.

So how can we achieve this?

Improving the attractiveness of general practice as a career choice.
We can do this by:

• Having a fully funded three-year training programme for all GP trainees. Currently GP trainees have to pay for their own training after the first year.
• Increased exposure to general practice (in urban and rural communities) throughout medical school and postgraduate years
• Developing rural specific training to support those who want to work rurally
• Remunerating the workforce for all the work that we do, not just the patient-facing time.

Recognise GPs who train the future generations. We want GPs to be recognised for their commitment to training so they can help grow all parts of the general practice workforce.

• Fund GPs who give up their time to supervise anyone learning in their practices.
• Recognise Fellowship in line with other medical specialisations.

Rectify the pay gap between primary and secondary care nurses. We want to grow and develop nurses in primary care to provide more services and undertake ongoing professional development.

• We need primary care nurses and healthcare workers to have complete pay parity with Health New Zealand Te Whatu Ora employed nurses and healthcare workers. Those working in primary care complete the same education and additional training and skills development as their hospital-based colleagues.

We have seen incremental change, such as the funding for urgent and after-hours care, which is a step in the right direction. What we need now are targeted decisions and swift actions that set the workforce up to be sustainable and future focused.

Investing in general practice will only have positive impacts on the communities we serve, the health and wellbeing we support and the people we care for.

Doing so saves the broader health system money and is a positive investment for the taxpayer.

This was published on NZ Herald on Tuesday 20 May.