GPs say people are having to travel for hours just to get a 15 minute doctors consult, amid the doctors shortage that has seen about half the country's clinics close their books to new enrolments.
Photo:
They worry about the thousands of people who are finding themselves locked out of the overloaded system.
With no Invercargill GP clinics currently taking on new patients, Waihopai Heath Services director Dr Sier Vermunt said there was an estimated 3000 to 4000 people in the city who were not enrolled with a doctor.
The situation had become "pretty dire", he said.
"The care of our patients is decreasing ... from a public health point of view these people are going to be worse off. They'll be less healthy, they'll end up using more expensive secondary services - hospital services in particular. They'll turn up at A&E, they'll crowd the A&E and that's already happening. It's just overwhelming."
He had been trying to hire new GPs for his clinic for three years but said no one was interested.
In the meantime, the clinic is having to turn away casual visitors because the existing doctors are flat out.
Some people have been going to extreme lengths for a consult, he said.
"We've got patients who are travelling to Dunedin to get care; just for GP visits."
"We really are going to see dramatic adverse healthcare affects by the primary care sector being decimated" - Dr Tim Cunningham
Some Northland GPs believed they might be in an even worse situation.
In Kaikohe, Broadway Health GP Dr Taco Kistemaker estimated he had about 2000 patients on his books.
He said some people had been travelling for hours to get to get there, because the family doctors in Kaitaia and Kawakawa were not taking new enrolments.
"Kaikohe is still open ... not that we can cope, but there's no alternative for the people there. It's not close to a hospital ... I think the situation in Northland is dire, very, very dire," he said.
Whangārei GP Dr Tim Cunningham explained the work in Northland was "extra hard" because the region had high levels of poverty, complex health issues and a significant geriatric population.
His clinic, Central Family Healthcare, had also shut its books to new enrolments and he was working 70 hours a week to keep up.
He said efforts to lure more GPs to the region had been unsuccessful.
On top of the workload, which he said made general practice an "unbelievably unattractive" specialisation, he said GPs in Northland tended to get paid less, than other parts of the country.
"Last year in Northland they had 10 GP training places. They managed to fill seven of those. By the end of the year there were two left. One said 'well I'm going to Auckland where I'm going to get paid better' and the other one said 'well I don't want to be a GP, it's just too hard for nothing - and I'm going to do public health'," he said.
He said places like Northland were the canary in the coalmine for a primary care crisis.
"We really are going to see dramatic adverse healthcare affects by the primary care sector being decimated. There's some overseas evidence that if you spend a dollar supporting primary care it probably saves about four dollars down the track. That's treatment of blood pressure, diabetes, screening of other health things."
Cunningham believed the only solution was for the government to pour a lot more money and resources in primary care - and fast.
For most of the past 19 years, government subsidies to GP clinics had fallen short of inflation, he said.
In short, that meant GPs were earning less, and could not ask their patients to pay the difference.
Meanwhile, he thought the government had not done enough to attract more GPs to the workforce, and said he was "gobsmacked" the government thought GP clinics could keep coping with the status quo.
Given GP shortages are a global issue, doctors told RNZ they were not holding out hope for an overseas influx.