GP says morale 'incredibly low'

General practices are on the brink of closing down because of the Covid-19 level 4 lockdown, interim chair of GenPro and rural GP Dr Tim Malloy says.

"We know that the job is still only half done."

Dr Tim Mallory. Photo: ODT files
Dr Tim Mallory. Photo: ODT files
Dr Malloy told the Epidemic Response Committee today that GPs are facing financial uncertainty and the funding model needs revision.

Most of the work GPs do is accident-related, with almost a third of income coming from ACC, but this work has dried up, Dr Malloy said.

His own GP practice saw a 28% decrease in business, meaning it wasn't eligible for the wage subsidy, he said.

Infrastructure of primary care is eroding at a time we need to be building it back up, he said.

While the DHBs spent a lot on altering facilities for the worst case scenario, Dr Malloy said it seems they forgot to plan for the best case and GPs are feeling almost abandoned.

"Moral has reached an incredibly low point."

While things are beginning to return to normal for GP practices now that New Zealand has moved to level 3, Dr Mallow believes pre-pandemic behaviour will not return until a vaccination is created.

"As of yesterday, the demand shot up... I think most people feel they've put things off for what they consider is long enough ... there's an element of relief we're in level 3."

However, he says practices have undertaken a huge effort to ensure they are Covid-19 free and the word needs to get out that it's safe to seek health services, he said.

"If we don't act now to mop up the delayed diagnosis and treatment risk, we are going to have problems … but I think it's salvageable."

INCREDIBLY STRESSFUL TIME, SAY MIDWIVES

College of Midwives chief executive Alison Eddy says she's concerned pre-existing issues regarding midwifery funding and morale have been exasperated by the Covid-19 pandemic.

Community midwives have literally had to fill the gaps of other providers during lockdown and they've noticed a significant increase in work, she said.

That extra care is done at a cost to the midwifes themselves, she said.

Both structural inequality and funding issues have come to light during this time, she said.

For example in the early weeks of level 4, community midwives had to find and pay for their own PPE and were at the whims of the DHB, she said.

During the lockdown period, about 5000 babies were born.

One of the big changes for people included leaving hospitals very quickly after giving birth. People who had caesareans were leaving after a couple of hours, Eddy said.

Early discharge was a challenge for many, she said.

It's difficult to provide the appropriate care for someone within the first 15 minutes of a virtual check-up, she said.

"Midwives have noticed the lack of access to mental health and family violence services. It's been an incredibly stressful time for the midwives."

Eddy told the committee, one benefit of the lockdown has been babies having healthy weight gain because there hasn't been distractions during breastfeeding or pressure for parents to put unrealistic expectations on themselves.

Other speakers today are Association of Salaried Medical Specialists director Sarah Dalton, Geneva Healthcare chief executive Veronica Manion and Auckland University's School of Medicine professor Des Gorman.

The committee, chaired by National Party leader Simon Bridges, was set up to empower MPs to scrutinise the Government's response to Covid-19 in the absence of Parliament. It is still sitting even though Parliament returned this week in a limited capacity.

The Government's response has been questioned, particularly with regard to access to financial support for GPs and access to personal protective equipment.

General practices last week accused the Government of blocking funding to stay afloat during the second half of the Alert Level 4 lockdown.

The Ministry of Health said the $22.4 million package was part of an "ongoing conversation" with the sector and the Government.

- RNZ and NZ Herald 

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