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Family doctor services are struggling to attract and
retain nurses, as they compete with a growing pay gap
between their nurses and those employed in the country’s
hospitals.
New Plymouth’s Devon Medical Centre has
lost two nurses since the start of the year, with Director
Dr Pat Leary saying the nurses left as they got paid more
elsewhere.
Dr Leary says in both cases it was a
situation of “money talks”.
An Employment
Relations Authority (ERA) ruling in December last year
significantly increased the pay disparity between nurses
employed in general practice and those employed by Te Whatu
Ora. The pay gap now stands at between 22%-27%, depending on
experience. It was previously up to 5.4%.
GenPro Chief
Executive Philip Grant says the pay gap is creating huge
challenges for essential family doctor services throughout
New Zealand and it is making it incredibly difficult for
general practices to attract and retain nursing staff. It
means patients increasingly can’t access some services or
are having to wait longer to get an appointment with their
family doctor team.
“Our member survey in late 2022
found that nearly half (46%) of family doctor services had
lost at least one nurse in the previous three months and
half of all practices had a current vacancy for one or more
nurses.
“You can’t blame nurses choosing to work
in hospitals, rather than a family doctor practice, when
they get paid $20,000 more in a hospital position,” Mr
Grant says.
“The government has just funded a
significant pay rise for hospital nurses, what we need is
for them to level the playing field and do exactly the same
for family doctor services so that they can deliver the
essential front-line services families need.”
Mr
Grant says advocating for pay parity and pay equity for
general practice nurses is the Association’s key
focus.
Dr Leary says his medical centre cannot compete
with the pay gap, as it is constrained by non-negotiable
government funding as well as by a government-imposed cap on
patient fees. “We simply can’t put up our fees any more
in order to pay our nurses more, even if we wanted
to.
“The reality is we have a limited market and the
hospital part of the market is funded to be able to pay
more. While that continues, we will see a shift of nurses
within the market,” Dr Leary says.
“The issue is
not just money, as it takes time and effort to take on a new
graduate, train them and for them to get the broad range of
knowledge and skills to be a good practice nurse.
Unfortunately, as in our situation it is often really great
younger nurses who are going to respond to the financial
incentive to move.
“We already have an aging
workforce of both nurses and doctors in General Practice
closing in on retirement. Without the lifeblood of younger
graduates being retained we are going to compound this
problem,” he says.
GenPro’s member survey was
undertaken between October and December 2022 (before the
December 2022 ERA ruling) and attracted 185 responses from
general practices throughout the country. It found current
workforce shortages and underfunding is impacting on service
delivery.
“We knew the situation was difficult, but
the survey has reinforced exactly how hard it is for family
doctor services,” Mr Grant says. “More than half of our
practices (53%) have reduced service levels due to the
workforce shortages and a significant number (36.5%) have
completely withdrawn some services altogether.”
Mr
Grant says it’s also difficult for families and whanau,
with 55% of practices having closed their books to new
enrolments.
“The challenging situation means that
vulnerable and high needs communities are missing out on
subsidised health care from a general practice and that will
be placing additional pressure on urgent care clinics and
already overwhelmed hospital emergency departments. We have
winter approaching which the experts are predicting will be
particularly challenging with respiratory disease, pneumonia
and on-going COVID cases. The government is looking to
family doctor services to help manage that demand but
without essential nurses there will be a huge gap in
services.”
The survey found that nurses are leaving
general practice to gain better pay within hospital
services, relocating domestically or internationally or,
exiting primary care altogether due to stress and heavy
workloads.
Many surveyed described the workforce
situation as ‘desperate’.
The results back
GenPro’s On
The Brink report released in November 2022, which
highlighted the precarious state of family doctor services
due to workforce shortages and underfunding and recommended
a nine-point action plan to ensure its future
sustainability.
On The Brink:
Saving New Zealand’s family doctor service can be
downloaded here: https://www.genpro.org.nz/docs/onthebrink.pdf
The
Government Review into General Practice funding can
be downloaded from the Department of the Prime Minister and
cabinet website here: https://dpmc.govt.nz/publications/proactive-release-future-capitation-funding-approach
GenPro’s
Open Letter to the Minister can be downloaded here:
https://genpro.org.nz/docs/openletter21-nov-2022.pdf
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