Patients are to be told they will be moved quickly
through hospital services if they have a GP's letter, rather
than turning up at southern emergency departments unannounced.
It is hoped the public will start to view going to the GP
first as a way to avoid long waits in hospital for less
serious health problems.
The move came as new figures show waiting times have become
longer in Dunedin Hospital ED, with 87% of patients seen
within six hours in May.
GPs would try to free up more on-the-day appointments to
allow more patients to be seen who might otherwise have gone
to hospital, Southern Primary Health Organisation chief
executive Ian Macara said. The idea came from GPs at a
meeting in Dunedin this week. Mr Macara acknowledged some GPs
expressed concern about the effect on after-hours services if
large numbers of patients were redirected.
Mr Macara would seek the agreement of senior health board
clinicians this week for the proposal.
''If they agree with it, then away we go.''
A GP referral system already existed, but it would be
formalised, and made more widely known to the public and to
hospital areas. It saved patients going through the whole
''shooting match'' in ED, in some cases giving them access to
specialty services immediately. The system was not designed
to prevent people from attending the ED for emergencies, but
would cater for situations in the ''grey area'', Mr Macara
''We're asking them to consider the best place for their
Southern District Health Board member Dr Branko Sijnja said
patients would have an incentive to visit the GP rather than
''What we want to encourage is that that is an advantage to
them, that that letter smooths the pathway through
''For a small cost, you do get a smoother service going
Dr Sijnja, who is also a GP, said some practices already kept
spots open for urgent appointments, and this needed to happen
The public needed an ''explicit'' message about visiting the
GP first, and they were good at self-triage to decide what
service was appropriate.
Asked if the proposal was further privatisation of the health
system, he said: ''That is the problem''. However, practices
worked with patients who had difficulty paying their bill, he
It made sense for patients to have as much contact as
possible with clinicians who knew their health needs.
Royal New Zealand College of General Practitioners medical
director Dr Samantha Murton, of Wellington, saw merit in the
proposal when contacted by the Otago Daily Times yesterday.
''It's much easier for [GPs] to give a steer on what we
think's happening than a person who doesn't know them at all
to go through the whole process of finding out about them.''
Cost was a barrier to receiving help from GPs, but there were
initiatives and payment options to provide more access. Much
depended on implementation; the ready availability of GP
urgent appointments was important to the proposal's success,
Dr Murton said.
Asked whether time or cost was more important to patients,
she said that depended on ''what you earn, really''.
''If you can afford it, time is an issue; if you can't afford
it, then time might not be an issue. But there are also
people [for whom] time is a huge issue, and they can't afford