Understaffed Lower Hutt clinic hires a a second doctor

• High Street Health Hub in Boulcott, Lower Hutt, lost most of its staff amid a national worker shortage
• Former staff have told RNZ it was due to feeling pressured to rush through patients, and nurses unwilling to work without GP supervision
• Patients have told RNZ they wait hours on the phone, and up to eight weeks for an appointment
• Health experts have warned a reliance on telehealth/virtual consults reduces the quality of patient care

A second doctor has been hired at an understaffed doctors clinic in Lower Hutt, which has had to rely on mostly virtual consults to accommodate its 9000 patients.

High Street Health Hub has had only one doctor completing in-person appointments, and they are based at The Doctors Silverstream in Upper Hutt.

The practice is one of 66 owned by Green Cross Medical, a New Zealand-owned and stock exchange-listed company. National operations manager for medical Andrew Tucker confirmed a second GP began on Monday, based out at Silverstream as well.

But the clinic's future remains uncertain, with the authorities not ruling out cancelling its funding contract unless it can provide better care.

Green Cross has blamed the national healthcare worker shortage for its problems hiring doctors, and Tucker said the clinic had been without a practice manager for a few months.

He said they expected to have five nurses and five GPs, both onsite and virtual, dedicated to High Street patients in the next seven weeks.

A job ad on Seek described the role as having "a great team culture and our GPs work closely with a team of experienced health professionals", and promises "you will be working with a team of skilled nurses and GP colleagues and an experienced administration team, supported by a dedicated practice manager".

A number of patients have spoken to RNZ about their experiences with the clinic. According to one who got in touch recently - who RNZ has agreed not to name - she noticed doctors were leaving about a year ago.

"The last time I physically saw a doctor, I asked why they were all leaving, and this really stuck with me - she said: 'Healthcare shouldn't be a business and this clinic is treating it as a business. It's not about the patients, it's about the money'."

When that doctor rang her with some test results, she told the patient she needed a re-check in six months - but not to rely on the practice to remind her.

Meanwhile, on Friday night she was still waiting for a callback from the nurse, after making a request on Tuesday morning.

Read more about the clinic's issues here:

• Workforce shortage not sole reason for Lower Hutt doctors' clinic's lack of staff, PHO says
• Lower Hutt GP practice stops face-to-face consultations as staffing shortage bites

Wait times are improving - virtual care lead

Dr Kim Hurst, the head of its virtual care network, is one of eight doctors from around the country looking after the Lower Hutt patients.

"Just as we rebuild the team, we want to have everyone in a position where, when we move services back to High Street Hub, we can be sure that things aren't going to fall over again, and when we move back there it's in a really sustainable way."

For now, the team consisted of two on-site doctors, eight GPs from Green Cross' national virtual health team, plus two on-site nurses, a health improvement practitioner and clinical pharmacist.

But Hurst said wait times were decreasing all the time.

"What I would really reassure people with is that access is increasing all the time now," she said.

"We had to work through a big backlog in appointments when we moved over to this new system, and we've now caught up, and our waiting times are equivalent to other practices in the Hutt Valley."

An 'extremely unfortunate situation'

The clinic's funder - the Primary Health Organisations (PHO) known as Te Awakirangi Health Network - said it was still in discussion with Green Cross about its plan to meet its contractual obligations.

PHOs distribute government funding to GPs, and can deduct money for services not delivered, or even cancel contracts.

Chief executive Cherie Seamark said it was their "preference" to work with the company to resolve what she called an "extremely unfortunate situation", but they were considering "all options" open to them.

Clinics are funded a certain amount per patient to cover their care for the year. If those patients don't book many appointments, the clinic banks the funding.

According to its 2024 annual report, Green Cross' medical revenue was up 5 percent last year to more than $140 million, although operating profit fell slightly to 15 million - mainly as a result of Covid-19 activity and labour cost pressures.

As of 31 March, it had 423,000 patients enrolled across its clinics - up nine percent in a year.

A balancing act

Associate professor of health policy at Otago University Robin Gauld said there could be a perverse incentive for some practices to enrol more patients than they could care for.

"Like all private general practices, they need to work to generate a profit, because at the end of the day that's the business model that they operate, so there may well be some tensions there."

GenPro chair Dr Angus Chambers, who represented general practice owners, said many were just trying to balance patient care with staying financially viable.

"And then the other really difficult question is, do I close my books so that people who are in great need cannot get an appointment in my community, or do I keep them open, knowing that if I really struggle to service this population, that at least they've got some health care available?"

Health New Zealand said it was in regular contact with Te Awakairangi to urgently resolve problems with GP access at High Street, but direct responsibility for ensuring patients have care lay with the PHO.