General practitioner in tears as ‘health system falls apart’

A North Shore doctor says he wakes up at 4 a.m. worried about his patients after working grueling 12-hour shifts and seeing up to 62 patients a day.

“I’m exhausted and I’ve already cried…the whole healthcare system is collapsing,” Northcare Accident & Emergency medical director Peter Boot told the Herald.

His comments come as hospitals across the country have been inundated with people battling Covid and other winter bugs. GPs were also seeing an overflow of patients diverted from overwhelmed emergency departments due to long waits.

New data, released under the Official Information Act, has revealed nearly 3,000 patients waited more than six hours for treatment at New Zealand’s busiest emergency department last month.

The goal is for 95% of emergency patients to be admitted, discharged or transferred within six hours.

Last week, the Herald reported that a ‘healthy’ 50-year-old woman died of a brain haemorrhage after she was allegedly told by emergency room staff at Middlemore Hospital that there would be a eight-hour wait before she was examined, triggering an urgent examination.

Health Minister Andrew Little acknowledges the huge workload of GPs and says it is not sustainable. Photo/Mark Mitchell

Boot said Monday was the busiest day he had seen in his nearly 40-year career.

“It’s terrible, it’s very, very hard. However, I come from a family of doctors and we’re not quitters,” Boot said.

Lately, Boot had started work at 7 a.m. and hadn’t left the clinic until 7 p.m. On Monday, he saw 62 patients, many of whom came from emergency rooms where wait times were unbearable.

To perform “proper and safe medicine”, a GP would need to see around 20 patients a day, he said.

“It is very bad.”

He said some people couldn’t see their own GP because doctors were tired and had “given up during Covid” or were afraid of dealing with respiratory illnesses.

“There aren’t enough doctors and they’re just overwhelmed and out of appointments.”

“I had to cancel my last three days off and I usually wake up around 4am thinking about my patients and the scary issues at the moment.”

Broadcaster Toni Street took her injured child to Boot’s clinic to treat a head injury on Monday.

Yesterday she thanked the overwhelmed medical staff and revealed to the Herald that her son was Boot’s 58th patient that day and the doctor was close to burnout.

OIA figures show Middlemore Hospital’s emergency department managed just 68% of patients within six hours last month, leaving 32% (2,791) waiting longer than the target treatment time .

Delays at South Auckland’s emergency department have worsened significantly since last winter, when 79 per cent of patients were seen within six hours, still below the target.

However, Health Minister Andrew Little disputed the data, saying emergency room wait times fluctuated and it was impossible to establish a trend from a month ago.

“One month’s data doesn’t paint a picture of the system as a whole. Winter is a particularly bad time, they have bad months because suddenly a lot more people are showing up. We have a huge increase in this moment.”

The Department of Health will work with “problematic DHBs” to help alleviate patient overflow when worrying trends are identified, he said.

Few acknowledged that GPs were working “extraordinary hours”, which was not sustainable.

He suggested GPs might need to reassess their workload.

For example, “if someone with muscle strain but is otherwise healthy and fit needs to see a GP or can go straight to a physiotherapist”.

Little also suggested that someone who felt “fluy,” but was otherwise healthy, could be seen by another medical professional, such as a nurse practitioner.

National health spokesman Shane Reti said a comprehensive plan was needed for after-hours care. Photo/Mark Mitchell

National health spokesman Shane Reti said OIA data showed the longest wait for a patient at Middlemore ED last month was 11.5 hours.

Reti said doctors working in primary care were absolutely exhausted.

A comprehensive plan was needed for after-hours care, in light of Middlemore’s passing.

On Friday, the Herald revealed that 18 out of 20 district health boards failed to meet this national standard between October and December last year.

The medical director of the Royal New Zealand College of General Practitioners, Dr Bryan Betty, said general practice and hospitals were at capacity and the country was in crisis.

He said GPs were already struggling with staff shortages and a winter spike in flu cases associated with Covid-19 was putting further pressure on practices.

“It’s short term, there are longer term issues here about how we strategically address the issue that has arisen which is the lack of manpower in some areas of New Zealand to provide care.”

Betty would like to see the government and Health NZ develop a strategy to address the shortage of GPs and nurses.

Reti has criticized the government, saying it is letting New Zealanders down sick when they need it most.