The Far North’s GP crisis is deepening with Kaitaia’s biggest medical practice forced to withdraw its services from the town’s only aged-care home.

That leaves 55 of the 98 elderly residents at Switzer Residential Care without access to a doctor.

From next month the only way the residents, many of whom have complex health needs and little mobility, will be able to access GP care is if they are taken by ambulance to the A&E department at Kaitaia Hospital.

The Far North’s GP shortage is nothing new — all three Kaitaia medical practices stopped accepting new patients in 2019 — but this week’s development shows the situation is worsening.

In a letter sent to residents’ families on Tuesday, and passed on to the Age, Switzer Residential Care chief executive Tina Mills said the home had been informed in November that staffing at GP practice Te Hiku Hauora had become “very precarious” with no locums (short-term doctors) available beyond this month.

That meant Te Hiku Hauora could no longer care for Switzer residents and would end its service contract on March 31.

“An ongoing shortage of general practitioners… has compelled Te Hiku Hauora to cease attending to our residents. It is unlikely that another general practice will be able or willing to accept Te Hiku-enrolled residents,” Mills wrote.

“We have been trying our best to find a solution to uphold every New Zealander’s fundamental right to be registered with a general practice. In this case, 55 residents have been abandoned by their GP clinic, and to date, we have yet to establish a reasonable, affordable alternative.”

Mills said the rest home had been negotiating with a national general practice provider, a Whangārei medical centre and a retired GP about a replacement service.

So far the only realistic outcome seemed to be that any residents who needed to see a GP would be transported to Kaitaia Hospital’s A&E.

Another interim solution could be to extend the rest home’s contract with a virtual service provider, but that business also had issues finding GPs.

“We are acutely aware of how inconvenient and substandard these options are for our residents,” Mills said.

“Without the support of Te Whatu Ora-Health NZ, the Northland PHO (primary health organisation), and others, we will not resolve this issue. It is disheartening that the Ministry of Health has failed to acknowledge the significant problem that Kaitaia and the wider Far North region face.”

Mills pledged to keep families informed and “do anything” to achieve a positive outcome for the residents.

Former Mayor John Carter, now chairman of the not-for-profit Claud Switzer Memorial Trust which runs the rest home, said he was “absolutely” concerned for the residents.

“Unfortunately Te Hiku Hauora have got to the stage where they don’t have enough staff. It’s been coming for a while — it’s a major problem across New Zealand and in the Far North especially. We’ve been trying to make other arrangements but we haven’t been able to make progress.”

If residents had to go to Kaitaia Hospital to see a GP they would have to cover the cost of the visit plus ambulance transport, currently $200 for the return trip.

Those costs would place a significant burden on some families, Carter said.

One solution could be to permit the “highly skilled and qualified” registered nurses at Switzer to take on part of the GP’s role — something they were capable of but not allowed to do, even for minor ailments, under current rules.

Carter also believed there were qualified doctors who wanted to come to New Zealand but immigration rules made it too difficult.

“Unfortunately we’re not getting the response we expect from health officials. We need our MPs to get involved as well. We need to resolve this GP crisis quickly, and anything the community can do to support us will be very, very welcome.,” he said.

Te Hiku Hauora practice manager Cheryl Britton said the decision to pull out of the contract had not been easy and she understood it could be upsetting for residents who had been Te Hiku patients for many years.

However, GP staffing levels were “in crisis” and Te Hiku no longer had the capacity to care for Switzer residents.

GP Kathy Bakke had visited all 55 residents to tell them what was happening, Britton said.

Te Tai Tokerau MP Kelvin Davis said he was aware of the shortage of GPs in Northland, and the Government was working to streamline systems allowing international health professionals to work in New Zealand.

That included speeding up the process for getting overseas qualifications recognised and a six-month bridging programme to prepare doctors for work in New Zealand, with their salaries paid during induction and training.

A one-stop international recruitment service had been set up within Te Whatu Ora to streamline the process of hiring overseas staff.

“These skill shortages do have a big impact, particularly in largely rural areas such as Northland, so it’s important we do all we can to not just attract staff from overseas but ramp up the training of doctors in New Zealand as well,” Davis said.

Another 36 residents at Switzer Residential Care are registered with other GP practices and are not affected by Te Hiku Hauora’s withdrawal.

Te Whatu Ora and Northland MP Willow-Jean Prime have also been contacted for comment.

In May 2019 Kaitaia’s three medical practices — Te Hiku Hauora, Broadway Health and Top Health — announced they could no longer accept new patients. The only exceptions would be the future children of existing patients.

They said the decision had been difficult but they had to commit to the patients they were already caring for.

People moving to Kaitaia were advised to stay enrolled with the GP practice in their previous hometown.

In December the Advocate spoke to a Kaitaia woman, Stella Rickit, who had spent three years trying to enrol with a local GP. The answer was always an apologetic “the books are full”.

Instead, Rickit, who is in her 60s, and her whānau waited until medical problems became too serious to ignore then made the 700km round trip to Auckland where they were still registered with their old GP.

According to Te Whatu Ora figures, just over half (59 per cent) of Northland’s 46 GP practices are enrolling new patients. The remaining 41 per cent have closed their books.

More than 11,000 Northlanders, most of whom are Māori, are thought to be not enrolled with a general practice.