Angus Chambers: "GPs know about long wait times more than anyone"

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The government wants to add GP weight times to the list of healthcare targets. So we've had health had healthcare weight targets for a while now with emergency rooms specialist selective treatments, and it doesn't seem to have made a hell of a lot of difference. Health Minister Simeon Brown. He's at the ground running, isn't he. He says there are far too many people waiting more than a week to get a doctor's appointment and this could change that.

And the jen pro that is the General.

Proactive Owners Association chair Angus Chambers is with us, and I think he's with us.

No, Hello, how you go?

Sorry, just had a couple of technical issues distract me in the background there.

That's okay. I can comment on environmental issues too, you know.

Hey, well you stay on the line afterwards. What do you guys? How do you feel about targets? Do they really do anything?

I have seen targets work to a degree.

I think there's always a concern with targets that they create perverse incentives and you design your behavior and a.

Target and sometimes miss other targets.

But look, when we had an immunization target quite a long time ago, general practice got very well up towards the target because of focus on it. So, yeah, there's an argument for them.

What's the incentive? And this is just a number in front of you. It's like having a pacemaker and a race, is it. You've got someone running at a certain speed in front of you and you're like, we got to keep up with this.

Look, there's a little bit of that.

I mean, you know, sometimes incentives have a financial part of it, So look, you know that's that's always helpful. I think there's an element of competition, and people don't like being lower down in a league table a personal pride thing, so that can sort of have some effect as well.

So how is it going to work?

Are you going to see is each practice going to sort of see how it sits with others? Is it some sort of thing where there's like a ladder that's sitting in front of everyone and these guys are winning, these guys losing.

Look, actually, we have no idea how it's going to be constructed, and we'd really like to be part of that because we know the situation in our business better than anybody else. I mean, you know, the Ministry of Health has really got very few clues around the delivery of general practice care. So the number one thing for us is to actually, let's work together. You want to achieve better weight times. Actually we want to achieve better weight times too, But there are ways.

Of doing it, in ways of not doing it.

So yeah, look, we don't know what the targets will be, but there's certainly a risk that it will shift behavior in a way that doesn't give the outcome people want.

Sometimes and what's an example of that, what couldn't we solve?

Would that be rushed rush service sort of thing, not giving people the right time they want the wrong diagnosis, that sort of thing, A.

Little bit of that.

But look, let's say you've got books closed because you just cannot meet the demands of the patience you've got already, and so it's an ethical thing to do to close your box and just look after the people you've made a promise to work after. If you're going to get more bunny to have open books at capacity already. If you open your books, you'll add more patients, there'll be more work to do, and wait times will grow so you know, you can see it working that way.

I think the.

Chances of people being unethical to cram more people in less high, although there is a risk of that, but you know, you want to do a good job and we have got ethics that dictate that you actually operate in a certain way.

So yeah, I think you said that.

You made a comment about we'd like to be part of it. It sounded like I got the impression you haven't been consulted about this. This is something you've read in the headlines, and it's like, oh, well, that's that's interesting to hear.

It's news to us.

One hundred percent. You know, no, they no involvement with the sect or whatever. There's quite a catch cry in patient care delivery is nothing about us without us, but it doesn't seem to apply to our service delivery models. But yeah, no, no, we haven't been consulted at all. We've been advocating for the increased funding that's come in, but you know it could be forcial in the way it's it's incentivized if it is in.

Actually, just can I dig into that a bit, because if I was a GP or as in your position as a major organization, I mean the General Practice Owners Association. I would feel pretty blim and annoyed that you read an announcement that there's going to be targets set to you when no one's spoken to you about.

Its welcome red. Yeah.

Look, I mean, perhaps I shouldn't be too outrageous, but you know, we hear over and over again that there's a very deep suspicion and even enmity towards general practice within the Ministry of Health, and you know, maybe that's true, maybe it's not.

We've had some very well connected people say.

It, and yeah, I think it's that rageous because not only is there that kind of you know, disappointment that we're not there, but we actually know it better than anybody else, and we feel like if we were able to contribute, we'd have a better outcome for all concerned, both the doctor's patients and the people who who want to see their policy succeed.

So what do you understand the announcement is?

So I'm going to need to dig into it a bit more because it's just, you know, I just assume you'd be all over this because the Ministry had consulted you with it, So all you know so far is that the government government wants to add targets for GP wait times and beyond that, you're none the wiser.

Well, let's look at the things we do know.

Is there's ninety five million dollars that has been dedicated to increasing what they call capitation's fees you get for looking after patients from the state. And then there's been it's been talked about that there'll be incentives to improve the access and the minister did mention open books. I have spoken to an official more since since he said that. He said, actually he doesn't think it's going to operate like that, but you know, you have to rely on

But yeah, so those kind of things.

So in reality, in terms of getting us moving along and people not having to wait so long for a GP appointment, what are the things you would really like to see?

Well, look, actually, all hinges on workforce and if you don't have enough staff to deliver service and you can't get them, you're behind it from the very beginning. And look, this is this is a problem of decades in the making. You know, all of the demographics of the general practice workforce and all the analysis said that we're going to reach this sort of shortage time around about now because there's so many people retiring. It's been compounded by somewhat

Going to take a long time before it comes into effect.

Where we kind of employer doctors, well we can employ them, we can't find them to employ right now. And this money will help, but it's not going to fix it soon. And there's alternative work workforces that are coming through, and look, you know we use a lot of that at our practice already.

But it's a hard talk with either are you're.

Talking about the overseas doctor qualification the way that they can get certified more efficiently, I guess or quickly in nurse.

Per Yeah, that's one of them. Nurse practitioner training. There's a group call physicians Associates and look, and there's quite a lot of dispute around all this stuff, and there is certainly some evidence that they'll actually cost the system more because there order more tests, refer more people into the secondary care, which is vastly more expensive than dealing with them efficiently and effectively in the community.

So would it be fair for me to say, great, we love the announcement. It's good to try and do something, but a little more consultation wouldn't hurt.

Yeah, Look, it's definitely a good start. It's hard to begrudge.

You know, we're getting extra funding when you know a lot of people are having cuts.

So it's a good start.

We think, cork with us and we'll actually make the money work better. And yeah, in the future, we'd really like to have a bit more input around the design of the system because we know better than anybody else how it works.

Oh, good stuff.

Obviously, if you're a part of the General Practice Association, you've got your own practice, how are you coping in your practice?

Look, it's abs and downs, it's quite it's quite hard work. I mean, there's a lot other things to say about the extra demands that have come through the General Practice over the last you know, the end of twenty years. But you know, it's really unfortunate for us. We've just had three doctors indicate that they're going to be moving on, and they're all quite legitimate reasons.

That Australia Australia, Australia.

Oh look, one has a spouse who's got his own practice and that she's probably gonna move there, and you know, we have lost them to Australia before.

But none of these particular ones are going to Australia.

Oh, I really appreciate your time on the staffening and angus. You can't stick around and comment that on Chris Pink's announcement.

You'd have to brief me a little bit first, but yeah.

Hey, thanks very much. I thanks, really appreciate it.

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