Doctors on dole by 1986?

Press, 9 August 1980, Page 11

Doctors on dole by 1986?

Health reporter

Doctors in Christchurch have been told to reassess their relationships with other health workers. The Minister of Health (Mr Gair) said that this action would be necessary to cope with the fact there might be 1000 unemployed doctors by 1986.

The role of other health workers would form an important part of a detailed report on medical manpower, Mr Gair told the Christchurch branch of the New Zealand Medical Association.

This report would be available in about two months. In the meantime doctors needed to accept the fact that shortages of Government finance for health and the likely surplus of doctors by 1986 might force a second 12.5 per cent reduction in the intakes to medical schools.

Mr Gair said it was the responsibility of the medical profession to “chew over data’’ and to come up with recommendations on how best to use the coun-

try’s medical manpower resources, with efficiency, economy, and the minimum of wastage. In Christchurch by 1986 only 20 more general practitioners would be needed to maintain the general practitionerpatient ratio.

In accepting this fact, which might be unpalatable to some doctors, the role of such people as pharmacists, social workers, physiotherapists, practice nurses, and chiropractors must be considered.

Physiotherapists, for example, often felt that they were more able to decide which particular treatment was suitable for patients than was the prescribing doctor. “You as medical practitioners must think deeply on your relationships with these people, all of whom are working in your particular field and all of whom are seeking a place in the sun,” Mr Gair said. Mr Gair gave special emphasis to, the place of practice nurses — regis-

tered nurses employed by f eneral practitioner’s. The, 75 doctors throughout’ the country who employ 836 practice nurses receive a 100 per cent Government subsidy for doing so. More than $6 million was spent on the practice nurse scheme last year but it is now under serious reconsideration.

Suggestions that the practice nurses might usurp part of the doctors’ work have been made and a committee has been set up to review the scheme. Originally set up in 1970 to assist doctors in rural areas, there are now more- practice nurses working in urban settings than in rural areas. Only 39 practice nurses work with rural general practitioners, while 836 work in urban areas. The scheme has been open to abuse by some doctors who have used nurses employed under this heavily Governmentsubsidised service for nonprofessional duties such as office reception work.

Mr Gair said he was disappointed with the small amount of home visiting which has resulted from the practice nurse scheme. The amount of duplication between public health nurses, district nurses, and practice nurses was also a matter of concern. “There are some worries about practice nurses being unduly involved in the prescribing, and particularly the repeat prescribing, of medicines,” he said.

The career structure for the practice nurses required careful examination and doctors must always ensure that they saw patients personally if they wanted to claim a Government benefit for them.

The forthcoming review of the practice nurse scheme would be of vital concern to all general practitioners, Mr Gair said. He was adamant however, that the advantages of the scheme far outweighed the disadvantages.