A chronic shortage of family doctors in Northland means some patients turning up at Whangarei Hospital's emergency department are sent away with a voucher for the city's private emergency clinic.
People are being turned away from Whangarei hospital with vouchers. Photo: Google Maps
Most medical centres are so stretched they cannot accept new patients, and many have a two-week wait for appointments.
Each day Whangarei Hospital's emergency department sends away about eight non-urgent patients with vouchers for free treatment at the emergency clinic.
Whangarei teacher Miriam Burgess-Payne said she is concerned and frustrated that people have to go to the emergency department for same-day medical care.
"On the Northland DHB Facebook page we're getting things pop-up from them saying please leave ED for emergencies, which is true it should be for emergencies, but if people have got no other option they're having to use emergency services," she said.
As a mother with two children under five, she knows how hard it is to wait two weeks to see a GP.
"At my GP clinic the first thing they'll ask is if the person needing an appointment is sick, which is an unusual question because if you're calling a doctor it's usually because you're not well," Burgess-Payne said.
"They'll put me on a wait list to see a nurse if it's really urgent, otherwise I have to wait a couple of weeks."
Her frustration at the long wait times to see a GP led her to start a petition on change.org, calling for urgent political action to get more doctors in Northland.
It attracted over a thousand signatures within a fortnight.
"It's talked about a lot on social media platforms and mum groups it's an issue for a lot of people, which was one of my reasons for starting a petition. There's no point in complaining about it if it's not being heard by the right people," Burgess-Payne said.
"I don't know what the answer is, we just need more doctors up here so people aren't having to wait huge times just to see someone."
But it's not only patients in the deep end - Onerahi Family Healthcare had to close a satellite clinic at Parua Bay when two of its GPs retired at the end of last year.
Its regional practice manager Dale Te Iwimate said they've put a lot of work into recruiting two new GPs from overseas, who won't start for at least four months.
"We could open that tomorrow if someone magically said, here I am I want to work for you, we could open Parua Bay tomorrow."
Northland public health organisation, Mahitahi Hauora, is charged with supporting the region's general practice workforce.
Its chief executive, Phillip Balmer, said several region-wide responses - including employing locums to fill gaps and recruiting GPs from overseas - are starting to address the chronic GP shortage but won't address the systemic underfunding.
"The practices have had some success in recruiting and I'm pleased to see overseas GPs coming in and wanting to be here and part of the landscape."
Balmer said an ageing GP workforce and ever-growing population with more complex health needs continue to fuel the chronic shortage.
"There's no way that the situation in Northland or in other parts of New Zealand is optimal. If I'm newly arriving in a city and take for granted things like getting access to a GP and being able to enrol, the fact that I have to work hard to enrol makes me anxious about the level of services available to me."
He said there were 182 GPs in Northland, including six new recruits in the last three months.
All bar one practice in Kaitāia were now accepting new patients, with the fourth due to open its books next month.
But only four of 22 practices in the Whangarei and Kaipara area are accepting new patients - showing how widespread vacancies are.
A nationwide survey last year showed a third of practices had vacancies for GPs.
Northland MP Shane Reti is a GP and knows first hand how desperate the shortage is - he keeps up his registration with locum work in Whangarei.
"I've heard comments from my colleagues that they can't continue like this and I've been aware of the stress they're under, certainly in Whangarei, for several years now," he said.
"Here in summer if we're already creaking at the seams, I've got concerns for what winter might bring."
Dr Reti said more needs to be done to attract medical professionals to the specialty, including setting up a new medical school to train rural doctors.
"There's no quick fix because to grow a doc takes at least seven to eight years in the standard model. In the model we're proposing for a graduate rural medical school, you would already have an undergraduate degree then we take you through the four years in medicine," he said.
"To get more doctors on the ground at this point we're relying on international medical graduates and we may well reach out to more of them."
Come April, representatives from Mahitahi Hauora will attend an Asia Pacific regional conference of family doctors, where they plan to promote Northland and recruit GPs.
They can't arrive soon enough for Miriam Burgess-Payne.
"My parents are moving to Northland, they're elderly, and I've got genuine concerns about them seeing a doctor when they need to see somebody."
She plans to send her petition to MPs and local leaders.