GPNZ 2020 Vision: Transforming To A Primary Care-led Health System

General practice leaders are calling for a fundamental shift in the focus of health services away from hospitals and towards community-based services in order to tackle New Zealand’s systemic health challenges.

General Practice New Zealand (GPNZ) believes that the health and disability system review, combined with the learnings from managing COVID-19, provide a unique opportunity to improve the health of all New Zealanders.

GPNZ CEO Liz Stockley said: ‘We need to seize this opportunity to transform the way we provide health services. To do that, the Government has to have the courage to shift the focus of care and funding from hospitals to primary and community services, and to shift services such as radiology, rehabilitation, minor procedures and the majority of management of long term conditions out of hospitals to where they are best placed for local communities.

‘The key purpose of our reset health system has to be keeping people well and keeping people out of hospitals, which are then free to focus on acute and emergency care that can’t be provided elsewhere.’

Chair and Karori GP Jeff Lowe said: ‘If we are to tackle our persistent health inequalities, if we are to improve the health of our most vulnerable communities, if we are to properly address New Zealand’s shameful record of conditions like heart disease, diabetes and mental distress we have to completely overhaul the way services are funded and managed.

The focus of our health system must be protecting and improving people’s wellbeing, not just caring for people when they get sick.’

Many general practices, Māori health providers and community organisations are working innovatively and collaboratively to improve the health of their local population, but our current system isn’t designed to make it the norm, Dr Lowe says. Though hospitals receive the bulk of health funding, even those resources earmarked for primary care are too often diverted to prop up hospital services.

Dr Lowe added: ‘This is the time to make primary care and general practice the hub of our health system. Our modern general practice isn’t just about patients booking a weekday 15-minute face to face appointment with a doctor and leaving with a referral or a prescription; it is also about helping people keep themselves well, partnering with people at every stage of their life and connecting them to culturally-appropriate support based on their individual needs,’

GPNZ believes that the Health and Disability review needs to:

• Shift the focus of health planning, investment and accountability from hospitals to primary care to achieve better health outcomes for all New Zealanders
• Ensure health resourcing is targeted where it can have the greatest impact for the most people, supporting affordable access to care, healthier lifestyles and reduced need for downstream services
• Create consistent opportunities for convenient and affordable access to in-person and virtual primary health care with seamless connection to a range of integrated services including allied health, diagnostics, social and community support and specialist consultations
• Ensure structures and incentives support collaboration rather than competition, creating a platform for stronger local relationships and improved flexibility and innovation in the way care is delivered.
• Agree and embed the principles on which a first-class New Zealand health system should be based; that includes ensuring that equity and Te tiriti o Waitangi are integral to planning and delivery at every stage in every service, underpinned by compassion, quality and partnership with people
• Create mechanisms for systematic and ongoing consumer/client/whanau participation and engagement locally and nationally
• Invest in the key enablers of an effective health system including workforce, data and technology.

Dr Lowe said: ‘GPNZ is looking forward to contributing to the development of the health system New Zealanders need and deserve. There is a lot of good work to build on, with the additional momentum created by our collective response to the pandemic. What we mustn’t do is go back to the “old normal”’.

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