GP stunned by loss of service

Dunedin GP Dr Stephen Graham says primary care workers should not be told to cover for a lack of...
Dunedin GP Dr Stephen Graham says primary care workers should not be told to cover for a lack of secondary care specialists. PHOTO: GREGOR RICHARDSON
The South is now suffering from the very postcode lottery the new health system was designed to avoid, a Dunedin GP says.

Portsea Medical Practice GP Dr Stephen Graham said in a career approaching three decades, he had never experienced a situation similar to the recent collapse of Southern Dermatology services.

"I find it remarkable that we have a secondary care service which has now ceased to exist in the South, only in the South.

"It’s the postcode lottery — I thought that’s what Te Whatu Ora was meant to get away from."

This follows the loss of two contractors who had been travelling to the South from elsewhere in the country to provide dermatology services, as reported by the ODT.

Health New Zealand Te Whatu Ora (HNZ) confirmed no new outpatient referrals were being accepted.

However, the organisation told the ODT on Friday it was looking into outsourcing options.

Dr Graham said he was not aware of any other instances where a secondary care service had been pushed on to primary care. This was done without any extra funding.

However, even if funding was provided, it would not solve the problem, he warned.

The situation was clinically unsafe.

Suspected skin cancers were under the remit of another department, but there were no longer any medical dermatologists to see people with conditions such as psoriasis or severe eczema, Dr Graham said.

"We do simple dermatology all the time, but a proportion of those ... have a serious problem that we need another opinion on.

"We’ve learned over time the access to dermatology services is very limited.

"But limited and zero are not the same thing."

This follows the release of University of Otago research last week showing the risk of being declined by specialist services despite a GP referral was 54% in the Southern health district in 2022.

Dr Graham also slammed HNZ for the lack of consultation with GPs about the situation.

It was not all right to make the change without understanding the effect it would have on primary care in terms of time and resources, he said.

Primary health network WellSouth also said it had been "advised" of the change, rather than consulted.

Chief executive Andrew Swanson-Dobbs said the health sector was under pressure in both in primary and secondary care.

"When services are no longer available in specialist secondary care, for example the recent reduction in dermatology provision, the solution is not to redirect patients to general practice unless it comes with funding and support for building capacity and capability."

However, he encouraged people to seek medical advice from their nurse or general practitioner.

HNZ Southern group director of operations Hamish Brown said only about 30 dermatologists were working in the public health system nationally, but the organisation was searching for permanent dermatologists to fill long-standing vacancies, as well as seeking locum cover.

"We are considering private options and have in the past used teledermatology services.

"We are working with our colleagues in Te Wai Pounamu to see what support they may be able to offer patients but the capacity for dermatology services is limited, both regionally and nationally.

"We have consulted with our GP liaison partners at WellSouth to advise them on the withdrawal of the service and we continue to work with them to provide continued support for patients who receive their treatments in the community."