Questions about which general practices in Northland are taking on new patients have become a weekly ritual online.

The Far North, in particular Kaitāia, has had to grapple with the severe shortage of available GPs.

Common circumstances that thread their way through queries are: “I’m new to town”; “my partner has just moved up”, or “my children need a doctor”.

Sadly, the most repeated phrase seems to be: “I probably already know the answer but am gonna ask anyway…”

While there’s no miracle cure to the shortage, the Advocate has taken on the task of getting the most practical advice from the professionals for those stuck without a doctor.

How did the GP crisis get so bad?

The doctor shortage has been going on for several years, Sandra Wilkinson, partnership services manager for Mahitahi Hauora says.

The finger is pointed at systemic issues as the root cause of the problem.

But the shortage has been exasperated by extra Covid care pressures, vaccine mandates, border closures barring international doctors, and visa restrictions causing some doctors to return overseas, Wilkinson said.

Adding to the strain is the influx of newcomers to Northland, where one of the lowest doctor-to-patients ratios in the country currently exists.

Funding shortfalls have also been a long-running burden for practices. Most recently, GPs slammed the recent 3 per cent increase in primary healthcare funding as woefully insufficient to cover real-term costs for practices.

One of Northland’s longest-serving GPs, Dr Graeme Fenton from Moerewa Medical Services, described the crossroads doctors and practices are at.

“The crisis issue is now between ensuring people have access to a GP and keeping it manageable so we can survive with the numbers we’re getting,” he said.

Fenton started Moerewa Medical Services in 1967 and is yet to retire as he is still awaiting a replacement that will ensure the practice’s books stay open.

But recruiting new doctors is no easy feat in Northland.

“Kaitāia always had a problem attracting GPs – it’s just one of those areas,” Fenton said.

Add to that, the fact fewer graduates are choosing general practice – roughly 20 per cent rather than the 40 per cent needed to fill the gap.

Fenton hoped one day the Government would change tact and offer a lifeline in the form of greater financial appeal.

“People say that’s not what counts but if you could earn say $100,000 more in Kaitāia than you would in Auckland, where would you go as a young doctor?”

I need a GP: Where can I go?

While the majority of the region’s general practices have their books closed, the Advocate has confirmed 19 are currently enrolling patients.

When looking for a GP to enrol with a starting point is Healthpoint, Wilkinson advised.

Second can be the Mahitahi Hauora website which lists their practices with information about enrolments, fees and services.

“While there is no guarantee, it’s sometimes worth contacting your first choice practice to discuss your needs even if they are not actively enrolling new patients,” Wilkinson said.

“They may be able to fit you in, especially if you live locally to the practice and have health needs and or mobility issues that make it difficult for you to access another practice.”

Maureen Allan, clinical manager of Whakawhiti Ora Pai Community Health Centre, said their enrolments prioritised people moving into their service area from Cape Reinga to Motutangi.

But they were chipping in to help respond to the struggles in Kaitāia by vetting enrolment requests from residents with high needs and able to travel.

“Otherwise they just end up going through to A&E,” Allan said.

Hauora Hokianga/Hokianga Health were also doing their bit by allowing Kaitāia residents to re-enrol with their practice.

In Kaikohe, enrolments from locals are still being accepted by the town’s only GP – Broadway Health Kaikohe.

Broadway’s chief executive Jessie Hoskins said they saw it as their responsibility to the Kaikohe community.

“We have no capacity due to the shortage of GPs in our other locations, Kaitāia and Waipapa. However, there are larger practices supporting those communities.”

Bronwyn Barlow, medical centre manager of The Doctors Tui in Whangārei, said they faced enrolment challenges like many other medical centres.

While they have worked “extremely hard” to ensure they are able to continue providing “clinically safe” care in their “available capacity” , they had some limitations to taking on new patients – similar to other regions and most Whangārei medical centres, Barlow said.

“We do accept enrolments from new people coming to live in Whangārei but are unable to accommodate people switching between GPs locally.”

The enrolment circumstances of Whanāu Ora Community clinic in Kāeo have changed since the article was first published in the Advocate.

Unfortunately a lack of doctor coverage – due to GPs off sick or on leave – has meant the clinic has stopped enrolments for approximately a month.

I can’t get a GP: What do I do?

Both GPs and Wilkinson encouraged anyone moving about or into Northland to hang onto their current doctor.

Wilkinson said by staying registered with a GP people then had the option to access virtual care until they were able to find a Northland practice.

Other options were to potentially access primary care as a casual patient, at a local GP or accident and medical provider, such as White Cross in Whangārei.

Free around-the-clock health care advice is available via Healthline on 0800 611 116 or through the Ministry of Health website.

Wilkinson said people could also register their details with Mahitahi Hauora to receive advice and support.

“[…]And we seek to capture information about your experiences to help us better understand the scale and nature of GP access issues in Tai Tokerau.”

Is it ever going to get better?

That’s a tough question to which GPs say don’t hold your breath for any time soon.

Wilkinson said Mahitahi were working on some solutions to relieve the pressure on GPs and free up the capacity for clinicians to offer more patient appointments.

“This includes work with Northland DHB [district health board] to ease the after-hours care load on GPs in the mid and Far North.”

Options for increasing access to virtual care in Northland were also being investigated.

Initiatives were in place to offer medium to long-term solutions. These include the Tai Tokerau Medical Workforce Pipeline project.

The project aims to increase the proportion of medical graduates entering the primary care workforce in Northland. Currently, six medical students are completing placements at GPs in the region as part of the project.

Other initiatives are targeting increasing numbers or expanding the skillset of nurses or mental health professionals in general practice to ease the pressure on GPs.