Will telehealth solve the GP crisis?
The government is betting big on remote healthcare, announcing a new 24/7 telehealth service. But virtual treatment is not always a substitute for IRL care, GPs warn.
Mōrena, and welcome to The Bulletin for Tuesday, March 4.
In today’s edition: Scathing report reveals Wellington ratepayers paying hugely inflated water costs; Police use of high-tech number-plate recognition rapidly increasing; mortgage arrears hit an eight-year high. But first, the government believes telehealth could help address our chronic shortage of GPs. What do doctors themselves think of it?
Overseas doctors may staff new service
Online GP appointments are set to become a lot more commonplace with the announcement of a new 24/7 nationwide telehealth service. Health minister Simeon Brown says it will play a vital role in addressing GP waiting times, though doctors staffing the service may not necessarily be based in New Zealand. Speaking at Monday’s announcement, he said that “many of them will be from New Zealand” but “some of them may be GPs registered in New Zealand, but working offshore, able to support that service”, The Post’s Anna Whyte and Rachel Thomas report (paywalled).
How popular is telehealth currently?
While telehealth services saw a surge in uptake during the pandemic, usage has since receded. Research last year by the Health Quality and Safety Commission found that the proportion of GP appointments conducted via video call has never exceeded 20%, reports Mariné Lourens in The Press (paywalled). A Royal New Zealand College of General Practitioners survey showed “48% of respondents never use video call when engaging with patients, while 25% never use patient portals. The main reason cited for not offering remote consultations was a lack of demand from patients.” The numbers have no doubt increased since that survey was conducted in 2022, particularly in areas where practices have been forced to introduce telehealth services due to GP shortages.
Not a panacea, GPs warn
Many GPs are keen supporters of telehealth, arguing that any tool which gives patients better access to healthcare has to be a positive. On the other hand, Dr Bryan Betty, chair of General Practice New Zealand (GPNZ), tells Lourens he thinks the benefits of telehealth have been “oversold”. It “tends to be useful for singular and semi-acute problems, but there is an inherent danger that [the doctor doesn’t] get a comprehensive picture of the patient’s health”, he says.
Writing in The Conversation, health academic and part-time Northland doctor Kyle Eggleton cites research demonstrating how telehealth can encourage unsafe medical practices such as increased prescribing, and is unsuitable for a range of more complex health issues. “These end up getting pushed back onto face-to-face doctors to be managed acutely or in emergency rooms, thereby increasing the burden at these points of care,” he writes.
Funding for more primary care doctors and nurses
Along with the telehealth service, Monday’s announcement included a new two-year programme training for up to 100 overseas-trained doctors to allow them to work in primary care, reports the NZ Herald. The government will also help fund the recruitment of 400 graduate nurses a year by GP practices and other non-hospital providers through incentives of up to $20,000 per placement. “This helps attract essential healthcare staff where they’re desperately needed, particularly in rural areas,” Brown said. The announcement also includes a performance-based $285 million uplift for general practice over three years, starting from July 1.
Labour leader Chris Hipkins said that while “of course” he’d welcome more GPs, the health minister had dropped the ball on bigger-picture issues like illness prevention and early detection. He said the government had made the situation worse by cutting free prescriptions and underfunding the pharmacy-operated minor ailments service.
Have thoughts? Join the conversation in the comments.
Use of high-tech number-plate recognition exploding among police
Police use of number-plate spotting systems has almost doubled in a year, to around 2000 times a day, reports RNZ’s Phil Pennington. The systems, known as Automated Number Plate Recognition (ANPR), allow police to access CCTV footage of any car by automatically identifying its number plate. Two years ago the Public Defence Service said the systems presented "a real risk of going into the territory of mass surveillance" but judges have ruled ANPR does not constitute a search that requires any sort of police warrant.
Wellington ratepayers paying hugely inflated water costs
A damning report on financial management at Wellington Water has revealed that it is charging ratepayers three times as much as other “peer councils” for unplanned pipe maintenance. The report also identified one "incident of alleged theft". PM Christopher Luxon was scathing in response, calling the CCO a “basket case” that has suffered from “unique corruption that's been built up over a number of years”. Wellington Water chair Nick Leggett said he is considering whether to accede to calls for him to resign, the Herald’s Georgina Campbell reports.
While the CCO is in the firing line, so are the contractors it has worked with. It was “bullshit” to suggest contractors were not aware they were overcharging, said Wellington City councillor Ben McNulty, The Post’s Tom Hunt reports (paywalled). Now contractors would need to decide how they were going to pay back what they had “creamed off the back of ratepayers”, McNulty said.
Join us at The Spinoff Book Club
The best way to enjoy a book is by yourself, the second best way is with a theatre full of people. Books editor Claire Mabey will lead a conversation with avid writers and readers Duncan Sarkies, Carl Shuker, Courtney Johnston and more. Join us to hear about their favourites, their recommendations, and what to look out for in the year to come.
Huge win: I can finally go back to hooning past schools at dangerous speeds
For a while the forces of woke stopped me from running over schoolchildren in my vehicle. But thanks to the government, I’m back in business, writes Hayden Donnell.
Click and Collect
Auckland-based Canadian private equity tycoon James Grenon has taken a 9.3% stake in NZME, owner of the NZ Herald. Grenon was previously associated with The Centrist and NZNE, two alternative outlets that targeted people on the political fringes. (Businessdesk, paywalled)
Mortgage arrears have hit an eight-year high, while company liquidations rose 38% in the past year, according to a new Centrix report. The South Island experienced a whopping 67% increase in liquidations. (Interest)
Some Wellington ratepayers could save hundreds of dollars thanks to rate recalculations. (Stuff)
Auckland restaurant Monsoon Poon is closing, while gourmet bakery Little & Friday is fighting for its life. (NZ Herald, The Post)
Children eat melted plastic in ‘appalling’ school lunch (Stuff)
Shanti Mathias tallies three years of New Zealand's support for Ukraine. For Windbag, Joel MacManus argues that reviewing the Glenmore Street cycleway isn't such a bad idea. David Dempsey and Andrew La Croix consider how New Zealand's new framework will deal with the risks of carbon storage. Liam Rātana talks to families considering the gamble of having children while carrying a hereditary condition. Thomas Giblin rounds up the best movies and TV on streaming services this week.
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Telehealth, especially with someone who isn't your usual GP is really only suitable in limited circumstances and certainly not all. It's almost an ambulance at the bottom of the cliff. Consistency of care with the same GP has a huge amount of benefits for patients and doctors alike, huge amounts of research supports this.
The govts health initiative ignores the elephant in the room. Tele health is good in remote locations where specialists are not available and also for monitoring patients, particularly older people. But a GP or specialist at the end of the computer link is still needed . It has limitations. It depends on a high degree of patient health literacy and it gives a kind of tunnel vision picture. And the patient has no backup services available, e.g. surgery, if these are needed. It is a siloed approach which ignores the interaction between different departments of medicine, surgical and technical teams.
Health is complex and this govt just doesn't get it with their one size fits all and simplistic solutions.
Overall the package seems like an attempt to mollify the public rather than address the real problems. Govt would do better to focus on improving equity among medical graduates, including the thousands of people who graduate from med school but never make it into an internship and improving access for doctors trained outside of NZ.