GP Fee Hoopla Overlooks Nurses’ Potential

GP Fee Hoopla Overlooks Nurses’ Potential

The attention on Primary Health Care generated by last week’s release of both the National Party’s Health Discussion Paper and the report on the Primary Health Care Strategy Evaluation overlooks the potential for nurses to have a much greater role in the provision and accessibility of primary care.

The New Zealand Nurses Organisation says that the interim report on the Government’s Primary Health Care Strategy is almost entirely focussed on GPs. The report notes only that there has been an increase in nursing consultations and that further data is required before an exploration of the proportion of nursing visits is carried out.

“The increase in the number of patients seen by a nurse is pleasing, but opportunities for nurses to make a much greater contribution to primary health care and case management continue to be missed,” says Chiquita Hansen, Chairperson of the Primary Health Care Nursing Advisory Council, NZNO. “Nurses have a long history of delivering the very best primary health services. Plunket Nurses, for instance, are some of the best known and most respected healthcare professionals in New Zealand. There is ample scope to develop the roles nurses play in improving the quality and accessibility of primary health care.”

Nurse Practitioners

Nurse Practitioners have the potential to assist with improving the health of all New Zealanders and reducing the burden of chronic disease. They have the capability to lead the delivery of services that cross the traditional boundaries of specialities and settings. However, many funding agencies and providers overlook the opportunities presented by employing Nurse Practitioners, looking simply at the initial costs without recognising the substantial benefits. Chiquita Hansen says this is not only a problem in creating Nurse Practitioner roles, but also in establishing any service that falls outside the historically accepted ways of delivering health care services.

Nurse Practitioners establish long-term relationships with patients to assist with the management of chronic disease and self-care as well as being involved prevention programmes in the community.

Nurse-Led Clinics

In the UK, US and Canada, nurse-led clinics are being established to improve access to primary health services. Nurse Practitioners are able to diagnose common ailments and prescribe medication, freeing up limited GP resources for more complex cases. While the exact models used overseas may not necessarily suit New Zealand, the concept is one that NZNO believes offers excellent opportunities for improving the efficiency and accessibility of primary care.

Decision Making

Primary Health Organisations are required to involve all providers and practitioners, including nurses, in decision making. NZNO Professional Nursing Advisor Angela Clark says that PHOs need to make a greater commitment to including nursing representation at governance level. Angela Clark also says that the reintroduction of the National Primary Health Care Nursing Advisory Group is critical and urgent in progressing the Government’s Primary Health Care Strategy.

“There are over 40,000 nurses and only 12,000 doctors in New Zealand,” says Angela Clark. “The nursing workforce is crucial to developing increasingly innovative, responsive and efficient primary health care. It is vital that the potential nurses offer is properly realised.”

ENDS

Additional detail available here: Investing in Health Update 2007

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