Funding boost, permanent doctor ease health woes

West Otago Health Trust chairman Allister Body and West Otago Health Ltd practice general manager...
West Otago Health Trust chairman Allister Body and West Otago Health Ltd practice general manager Michele Stainburn were delighted when work on the new medical centre and ...

The July arrival of the West Otago Health's (WOH) new doctor, Dr Fons Captijn, at the medical practice in Tapanui and news of extra Government funding for rural general practices from next year has pleased practice general manager Michele Stainburn.

The Ministry of Health announced from July next year it would provide an extra $9 million over four years for rural general practices on top of the $13 million a year earmarked for additional support to better retain clinical staff and services.

Mrs Stainburn said during the past five out of the six years she had spent hundreds of hours and thousands of dollars sourcing replacement full-time doctors and locums locally and overseas for the centre.

They had employed about 10 different doctors during the past six years for varying lengths of service - many overseas-sourced - and were delighted Dr Captijn, from the Netherlands, signed a permanent contract.

''You have no idea of the stress and time wasted [sourcing doctors],'' she said.

She said the fight to recruit and retain doctors and locums was not peculiar to West Otago Health, but was common for rural practices nationally for many years, and she had heard of some closing due to recruitment troubles or funding problems.

Often doctors would arrive, stay for a short time before leaving, or get to the contract-signing stage and change their minds.

''Often it is their family that pulls the pin and we have to accept that.''

The centre could spend $60,000-$100,000 to secure a doctor from overseas on advertising, finder's fees and relocation costs.

Once the doctor arrived in Tapanui, they and their family might then decide that city living was more attractive and simply leave.

If she is unable to source a permanent doctor, she employs locums, who are expensive at about $900 a day plus associated costs.

''We have to do that or else they won't come,'' she said.

West Otago Health trust chairman Allister Body said the difficulties attracting doctors and locums had meant the medical centre encouraged their six part-time nursing staff to complete further study and training, to make the most efficient use of their experience and skills.

The nurses are on a seven-day roster on-call, which allows the doctor to work office hours, to make the position as attractive as possible.

The health centre services about 2300 people. If there is no doctor, the centre receives support from Gore's doctors, or nurses work under ''standing orders'', a ''bible'' that outlines illness symptoms and treatments.

We do what we have to to survive,'' Mr Body said.

Mrs Stainburn said the Government had encouraged more doctors into training several years ago and they were starting to filter through.

However, once a doctor was qualified, they still had to undertake several years of training under supervision before being allowed to join a solo rural practice.

She said the Government's rural bonding scheme, while a success in some practices, was not applicable in places like Tapanui.

Practices that qualified had to have a vocationally registered doctor employed to supervise the more junior doctor.

She said Ministry of Health funding had not kept pace with costs.

Mr Body had discussed Otago and Southland's recruiting and retention difficulties with MP Bill English, who sympathised and researched the issue.

Mr Body was told the Government figures for Otago included Queenstown and Dunedin, and as neither of those areas had any trouble attracting doctors, ''therefore, on average, the region doesn't have a problem.''

He said he would like to see the rules changed so numbers were town-specific rather than region-specific.

Mr Body said the costs of recruitment and retention often meant the difference between a loss and a profit for the centre.

''We have got to salt a bit away in the good years to cover those years we don't have a doctor,'' Mr Body explained.

The extra funding is in addition to the development of local alliances of practices, DHBs and Primary Health Organisations, which will work together to agree on services and appropriate funding arrangements.


Costs of sourcing an overseas doctor

- If a recruitment agency finds a doctor from overseas there is a $25,000 (on average) finder's fee.

- If the doctor agrees to come, there are relocation fees, overseas travel tickets and associated costs for the doctor and family, getting the doctor registered in New Zealand and paying for supervision and accommodation (there is a doctor's house) while here.

- New Zealand's medical council insists any overseas doctor needs to be supervised for a period, by a qualified New Zealand doctor, no matter how experienced or well-trained, and that costs up to $130 an hour plus travel costs.

- Locums are paid about $900 a day, and by going through recruitment agencies, there can be equivalent of a further 15% of their salary on top of that as a commission.

- The practice also has to pay locum's travel costs (including for their family), car hire, petrol and motel accommodation if a doctor's house is not available, as well as other associated costs.


 

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