View Article PDF

On the day 28 February 2020, the world changed for New Zealand, as it confirmed its first case of COVID-19. We, along with much of the world, were scrambling to understand this new virus—its transmission, its voracity and predilection for alveolar tissue, its mortality rate and most importantly, what this would mean for the New Zealand people and our health system.

March signalled a wholesale scramble for GPs and general practice. Could we protect ourselves and our patients adequately, and still provide the care that people needed—when they needed it? The first scramble was for personal protective equipment (PPE), particularly gloves and masks. Practices like ours immediately put in orders to our distributors for these, only to be told that they were not available, but would be on back order. Gowns and protective eyewear were also in short supply. Confusion reigned—did we need to wear PPE (or even just masks and gloves) when seeing people who didn’t meet the criteria for swabbing? How would we protect our other patients and our staff?

Those first two weeks in March in general practice were incredibly stressful for doctors and nurses as the information coming from the Ministry was changing daily, and there was no conduit for concerns to get to the Ministry. Furthermore, the costs of trying to meet the COVID threat were straining the sustainability of general practice, which was already under threat from a decade of chronic underfunding of capitation. The dedicated Healthline was understaffed as nobody realised just how many people would be trying to find out information, so patients who could not get through on their telephone lines inundated general practice with their questions and concerns. PPE was now available but the supply lines were tenuous. COVID numbers were increasing and GPs were struggling to contain the risk to their premises, their staff and their patients.

At this stage the response to COVID was still not fully coordinated, and the RNZCGP encouraged the Ministry to set up a primary care subgroup which could convey concerns to the Ministry through the Technical Advisory Group (TAG). At the same time there was mounting pressure from GPs to set up community-based assessment centres (CBACs) as had been used in the SARS outbreak in 2003. At that time some general practices became designated as CBACs while others were “clean” practices. The increasing risk seen and felt by GPs was real and tangible, and there was a strong feeling that there needed to be better separation between those being seen and needing assessment and swabbing for COVID-19 according to the current criteria, and everyone else.

By mid-March the PHOs were coordinating the supply of PPE to practices but there was increasing concern about the supply of swabs for testing, and capacity in the laboratories around New Zealand to process the swabs.

Then the Ministry announced that the flu vaccines had arrived in New Zealand and would be available for all those who were eligible for funded vaccination. The problem was that there was no advance warning and so general practice was (again) scrambling to organise how we might deliver vaccination safely to our patients. In my practice alone we had 4,000 patients who met the criteria for funded vaccinations—it is no small logistical feat to arrange to have that number vaccinated in a timely manner. But then the vaccine supply dried up. An anxious and fearful patient population was literally demanding flu vaccines (both in person and 80% of phone calls) and there were none to be had. Through this time, the Ministry was saying that there was sufficient flu vaccine in New Zealand to meet demand. That may have been an accurate observation but it wasn’t where it was needed. New Zealand by this stage was at Level 2 alert with limited public gatherings and small groups.

Then on the Saturday, 21 March, a recommendation came through from the RNZCGP to all GPs recommending an immediate switch from face-to-face consultations to virtual consultations. This followed information that came out from Italy suggesting that community transmission of COVID-19 was occurring though GP clinic waiting rooms. The idea was that about 70% of consultations could be held virtually in order to protect patients from unwanted and unnecessary exposure to community-transmitted virus. By Monday afternoon, 23 March (48hrs later), general practice had been transformed. Patients were contacted and advised that consultations would be by telephone, email or videoconference where possible.

That same day, two patients with COVID-19 were suspected to have been infected by community transmission, and New Zealand went to Level 3. Within 48 hours of that announcement New Zealand was in Level 4 lockdown. What happened in general practice is that the flow of patients into GP clinics just stopped. A combination of fear and anxiety about catching the virus encouraged people to stay at home in their bubble, and the perception that their general practices would be overwhelmed by COVID patients, meant that they also did not ring with their various concerns. General practice as we traditionally know it ended on 25 March 2020.

General practice is a conglomeration of small- and medium-sized businesses who operate almost entirely on cashflow. This is particularly true for those practices that are not Very Low Cost Access (VLCA) and so have a greater reliance on co-payments from patients. The switch to virtual consulting required setup costs including webcams, microphones, extra telephone lines and headsets. But at the same time, there was still a need to see patients for assessment of various symptom complexes, eg, chest or abdominal pain. However, patients stayed away, and did not contact their practices. Neither did they turn up at the emergency departments of hospitals, or accident and medical centres. It was as if there was nobody needing care.

What that meant for GPs is that cashflow dried up “overnight”. The number of consultations, whether virtual or in in person, plummeted by 50–80% within days. Suddenly general practices were in danger of becoming insolvent and not being able to meet their payroll requirements. The phones were still busy with staff (nurses and receptionists) fielding concerns regarding flu vaccines (that weren’t available) but nobody was wanting consultations.

Leaders in general practice, NZMA chief among them, met with the Ministry and the DHBs CEO representative, and agreed a rescue package for general practice for the duration of the Level 4 lockdown. There was also an injection of funding to general practices to recognise the initial costs of meeting the threat of COVID-19. This money was made almost immediately available to practices via the PHOs and relieved the pressure of insolvency for many.

It is now three weeks into lockdown and general practice is tangibly different. The waiting rooms are virtually empty, with a trickle of patients being seen for assessment or treatment. The CBACs are now up and running all over the country and have almost entirely taken over the assessment and treatment of COVID patients, apart from the occasional designated practice. Flu clinics are operating generally smoothly—patients drive up in their cars according to their appointment times (every 10 minutes) and are vaccinated while sitting in their cars, and then drive home to their bubbles. Bubble-sharers are vaccinated together; where individuals are vaccinated for the first time, they are asked to remain in the carpark for 20 minutes and toot their horn if they experience any reaction (none so far in my practice and we have now done over a thousand). Doctors are sitting in their offices, or in their homes working remotely, having significantly fewer (mainly virtual) consultations than previously.

Where have the patients gone? GPs are concerned that they are presenting later than they should out of concern for their own risk, and consideration for the health system. This consideration is misplaced—these patients still need to be “seen”—and the Ministry in the last few days have been saying this publicly. These patients may well resurface after lockdown has ended but with higher acuity, needing more urgent attention and even admission.

In order for the hospitals to be prepared for the potential influx of patients with COVID-19 elective surgery has all been put on hold and there have been no new first specialist appointments (FSAs) for the past four weeks. Those who had follow-up appointments and could be reviewed virtually have been, but the remainder have been deferred until after lockdown has ended and people can move more feely again. The real issue for general practice has been that many of those who had been referred for FSAs but had not yet been seen, have simply been returned to general practice. These are people with sufficient acuity and clinical need to be seen who have now just been declined, with a request to re-refer them if needed. This simply begs the question—either they needed to be seen or they didn’t. If they did, why then subsequently decline them? They could have been deferred and reinstated when clinics re-opened. Those who have had their elective surgery deferred will simply be getting worse and need more community care in order to manage, while waiting for their surgery post-lockdown. This kind of activity simply further increases the pressures on general practice at a time when it is already reeling under multiple pressures.

The frontline in New Zealand is not(yet) the hospitals and hospital doctors (they have not been inundated with COVID patients); it is the GPs and general practice. GPs have been faced with the most profound threat in COVID-19 to which they reacted swiftly, efficiently and effectively. They were then asked to make the most profound change to their way of working in the history of general practice in New Zealand, and did it over the course of a weekend. But these changes have taken an enormous toll on GPs, and general practice will never be the same again. GPs are anxious about their financial futures as consultation numbers are still significantly fewer than before lockdown. Contracted doctors are having their contracts ended or suspended, even though there is an expectation that consultation numbers will go up after lockdown has ended. Nursing staff have no guarantee of continued employment, and those staff at higher risk of COVID have had to be stood down. Managing the risk of exposure to COVID and the threat that represents to themselves, to staff and to their patients, needs to be managed on a daily basis.

General practices and the people who work there are the unsung heroes of this pandemic and need to be recognised for how they have responded to this challenge. In the weeks and months to come they will need the support of the rest of the medical community, and the public at large, for the outstanding effort that has been required of them to meet the COVID threat.

At the time of publication the Government has only paid $22m of the $45m support package promised to General Practice and the sector has been advised that the balance would not now be paid.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Kate Baddock, General Practitioner, Kawau Bay Health, Auckland.

Acknowledgements

Correspondence

Dr Kate Baddock, General Practitioner, Kawau Bay Health, Auckland.

Correspondence Email

kateb@kawaubayhealth.co.nz

Competing Interests

Nil.

Contact diana@nzma.org.nz
for the PDF of this article

View Article PDF

On the day 28 February 2020, the world changed for New Zealand, as it confirmed its first case of COVID-19. We, along with much of the world, were scrambling to understand this new virus—its transmission, its voracity and predilection for alveolar tissue, its mortality rate and most importantly, what this would mean for the New Zealand people and our health system.

March signalled a wholesale scramble for GPs and general practice. Could we protect ourselves and our patients adequately, and still provide the care that people needed—when they needed it? The first scramble was for personal protective equipment (PPE), particularly gloves and masks. Practices like ours immediately put in orders to our distributors for these, only to be told that they were not available, but would be on back order. Gowns and protective eyewear were also in short supply. Confusion reigned—did we need to wear PPE (or even just masks and gloves) when seeing people who didn’t meet the criteria for swabbing? How would we protect our other patients and our staff?

Those first two weeks in March in general practice were incredibly stressful for doctors and nurses as the information coming from the Ministry was changing daily, and there was no conduit for concerns to get to the Ministry. Furthermore, the costs of trying to meet the COVID threat were straining the sustainability of general practice, which was already under threat from a decade of chronic underfunding of capitation. The dedicated Healthline was understaffed as nobody realised just how many people would be trying to find out information, so patients who could not get through on their telephone lines inundated general practice with their questions and concerns. PPE was now available but the supply lines were tenuous. COVID numbers were increasing and GPs were struggling to contain the risk to their premises, their staff and their patients.

At this stage the response to COVID was still not fully coordinated, and the RNZCGP encouraged the Ministry to set up a primary care subgroup which could convey concerns to the Ministry through the Technical Advisory Group (TAG). At the same time there was mounting pressure from GPs to set up community-based assessment centres (CBACs) as had been used in the SARS outbreak in 2003. At that time some general practices became designated as CBACs while others were “clean” practices. The increasing risk seen and felt by GPs was real and tangible, and there was a strong feeling that there needed to be better separation between those being seen and needing assessment and swabbing for COVID-19 according to the current criteria, and everyone else.

By mid-March the PHOs were coordinating the supply of PPE to practices but there was increasing concern about the supply of swabs for testing, and capacity in the laboratories around New Zealand to process the swabs.

Then the Ministry announced that the flu vaccines had arrived in New Zealand and would be available for all those who were eligible for funded vaccination. The problem was that there was no advance warning and so general practice was (again) scrambling to organise how we might deliver vaccination safely to our patients. In my practice alone we had 4,000 patients who met the criteria for funded vaccinations—it is no small logistical feat to arrange to have that number vaccinated in a timely manner. But then the vaccine supply dried up. An anxious and fearful patient population was literally demanding flu vaccines (both in person and 80% of phone calls) and there were none to be had. Through this time, the Ministry was saying that there was sufficient flu vaccine in New Zealand to meet demand. That may have been an accurate observation but it wasn’t where it was needed. New Zealand by this stage was at Level 2 alert with limited public gatherings and small groups.

Then on the Saturday, 21 March, a recommendation came through from the RNZCGP to all GPs recommending an immediate switch from face-to-face consultations to virtual consultations. This followed information that came out from Italy suggesting that community transmission of COVID-19 was occurring though GP clinic waiting rooms. The idea was that about 70% of consultations could be held virtually in order to protect patients from unwanted and unnecessary exposure to community-transmitted virus. By Monday afternoon, 23 March (48hrs later), general practice had been transformed. Patients were contacted and advised that consultations would be by telephone, email or videoconference where possible.

That same day, two patients with COVID-19 were suspected to have been infected by community transmission, and New Zealand went to Level 3. Within 48 hours of that announcement New Zealand was in Level 4 lockdown. What happened in general practice is that the flow of patients into GP clinics just stopped. A combination of fear and anxiety about catching the virus encouraged people to stay at home in their bubble, and the perception that their general practices would be overwhelmed by COVID patients, meant that they also did not ring with their various concerns. General practice as we traditionally know it ended on 25 March 2020.

General practice is a conglomeration of small- and medium-sized businesses who operate almost entirely on cashflow. This is particularly true for those practices that are not Very Low Cost Access (VLCA) and so have a greater reliance on co-payments from patients. The switch to virtual consulting required setup costs including webcams, microphones, extra telephone lines and headsets. But at the same time, there was still a need to see patients for assessment of various symptom complexes, eg, chest or abdominal pain. However, patients stayed away, and did not contact their practices. Neither did they turn up at the emergency departments of hospitals, or accident and medical centres. It was as if there was nobody needing care.

What that meant for GPs is that cashflow dried up “overnight”. The number of consultations, whether virtual or in in person, plummeted by 50–80% within days. Suddenly general practices were in danger of becoming insolvent and not being able to meet their payroll requirements. The phones were still busy with staff (nurses and receptionists) fielding concerns regarding flu vaccines (that weren’t available) but nobody was wanting consultations.

Leaders in general practice, NZMA chief among them, met with the Ministry and the DHBs CEO representative, and agreed a rescue package for general practice for the duration of the Level 4 lockdown. There was also an injection of funding to general practices to recognise the initial costs of meeting the threat of COVID-19. This money was made almost immediately available to practices via the PHOs and relieved the pressure of insolvency for many.

It is now three weeks into lockdown and general practice is tangibly different. The waiting rooms are virtually empty, with a trickle of patients being seen for assessment or treatment. The CBACs are now up and running all over the country and have almost entirely taken over the assessment and treatment of COVID patients, apart from the occasional designated practice. Flu clinics are operating generally smoothly—patients drive up in their cars according to their appointment times (every 10 minutes) and are vaccinated while sitting in their cars, and then drive home to their bubbles. Bubble-sharers are vaccinated together; where individuals are vaccinated for the first time, they are asked to remain in the carpark for 20 minutes and toot their horn if they experience any reaction (none so far in my practice and we have now done over a thousand). Doctors are sitting in their offices, or in their homes working remotely, having significantly fewer (mainly virtual) consultations than previously.

Where have the patients gone? GPs are concerned that they are presenting later than they should out of concern for their own risk, and consideration for the health system. This consideration is misplaced—these patients still need to be “seen”—and the Ministry in the last few days have been saying this publicly. These patients may well resurface after lockdown has ended but with higher acuity, needing more urgent attention and even admission.

In order for the hospitals to be prepared for the potential influx of patients with COVID-19 elective surgery has all been put on hold and there have been no new first specialist appointments (FSAs) for the past four weeks. Those who had follow-up appointments and could be reviewed virtually have been, but the remainder have been deferred until after lockdown has ended and people can move more feely again. The real issue for general practice has been that many of those who had been referred for FSAs but had not yet been seen, have simply been returned to general practice. These are people with sufficient acuity and clinical need to be seen who have now just been declined, with a request to re-refer them if needed. This simply begs the question—either they needed to be seen or they didn’t. If they did, why then subsequently decline them? They could have been deferred and reinstated when clinics re-opened. Those who have had their elective surgery deferred will simply be getting worse and need more community care in order to manage, while waiting for their surgery post-lockdown. This kind of activity simply further increases the pressures on general practice at a time when it is already reeling under multiple pressures.

The frontline in New Zealand is not(yet) the hospitals and hospital doctors (they have not been inundated with COVID patients); it is the GPs and general practice. GPs have been faced with the most profound threat in COVID-19 to which they reacted swiftly, efficiently and effectively. They were then asked to make the most profound change to their way of working in the history of general practice in New Zealand, and did it over the course of a weekend. But these changes have taken an enormous toll on GPs, and general practice will never be the same again. GPs are anxious about their financial futures as consultation numbers are still significantly fewer than before lockdown. Contracted doctors are having their contracts ended or suspended, even though there is an expectation that consultation numbers will go up after lockdown has ended. Nursing staff have no guarantee of continued employment, and those staff at higher risk of COVID have had to be stood down. Managing the risk of exposure to COVID and the threat that represents to themselves, to staff and to their patients, needs to be managed on a daily basis.

General practices and the people who work there are the unsung heroes of this pandemic and need to be recognised for how they have responded to this challenge. In the weeks and months to come they will need the support of the rest of the medical community, and the public at large, for the outstanding effort that has been required of them to meet the COVID threat.

At the time of publication the Government has only paid $22m of the $45m support package promised to General Practice and the sector has been advised that the balance would not now be paid.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Kate Baddock, General Practitioner, Kawau Bay Health, Auckland.

Acknowledgements

Correspondence

Dr Kate Baddock, General Practitioner, Kawau Bay Health, Auckland.

Correspondence Email

kateb@kawaubayhealth.co.nz

Competing Interests

Nil.

Contact diana@nzma.org.nz
for the PDF of this article

View Article PDF

On the day 28 February 2020, the world changed for New Zealand, as it confirmed its first case of COVID-19. We, along with much of the world, were scrambling to understand this new virus—its transmission, its voracity and predilection for alveolar tissue, its mortality rate and most importantly, what this would mean for the New Zealand people and our health system.

March signalled a wholesale scramble for GPs and general practice. Could we protect ourselves and our patients adequately, and still provide the care that people needed—when they needed it? The first scramble was for personal protective equipment (PPE), particularly gloves and masks. Practices like ours immediately put in orders to our distributors for these, only to be told that they were not available, but would be on back order. Gowns and protective eyewear were also in short supply. Confusion reigned—did we need to wear PPE (or even just masks and gloves) when seeing people who didn’t meet the criteria for swabbing? How would we protect our other patients and our staff?

Those first two weeks in March in general practice were incredibly stressful for doctors and nurses as the information coming from the Ministry was changing daily, and there was no conduit for concerns to get to the Ministry. Furthermore, the costs of trying to meet the COVID threat were straining the sustainability of general practice, which was already under threat from a decade of chronic underfunding of capitation. The dedicated Healthline was understaffed as nobody realised just how many people would be trying to find out information, so patients who could not get through on their telephone lines inundated general practice with their questions and concerns. PPE was now available but the supply lines were tenuous. COVID numbers were increasing and GPs were struggling to contain the risk to their premises, their staff and their patients.

At this stage the response to COVID was still not fully coordinated, and the RNZCGP encouraged the Ministry to set up a primary care subgroup which could convey concerns to the Ministry through the Technical Advisory Group (TAG). At the same time there was mounting pressure from GPs to set up community-based assessment centres (CBACs) as had been used in the SARS outbreak in 2003. At that time some general practices became designated as CBACs while others were “clean” practices. The increasing risk seen and felt by GPs was real and tangible, and there was a strong feeling that there needed to be better separation between those being seen and needing assessment and swabbing for COVID-19 according to the current criteria, and everyone else.

By mid-March the PHOs were coordinating the supply of PPE to practices but there was increasing concern about the supply of swabs for testing, and capacity in the laboratories around New Zealand to process the swabs.

Then the Ministry announced that the flu vaccines had arrived in New Zealand and would be available for all those who were eligible for funded vaccination. The problem was that there was no advance warning and so general practice was (again) scrambling to organise how we might deliver vaccination safely to our patients. In my practice alone we had 4,000 patients who met the criteria for funded vaccinations—it is no small logistical feat to arrange to have that number vaccinated in a timely manner. But then the vaccine supply dried up. An anxious and fearful patient population was literally demanding flu vaccines (both in person and 80% of phone calls) and there were none to be had. Through this time, the Ministry was saying that there was sufficient flu vaccine in New Zealand to meet demand. That may have been an accurate observation but it wasn’t where it was needed. New Zealand by this stage was at Level 2 alert with limited public gatherings and small groups.

Then on the Saturday, 21 March, a recommendation came through from the RNZCGP to all GPs recommending an immediate switch from face-to-face consultations to virtual consultations. This followed information that came out from Italy suggesting that community transmission of COVID-19 was occurring though GP clinic waiting rooms. The idea was that about 70% of consultations could be held virtually in order to protect patients from unwanted and unnecessary exposure to community-transmitted virus. By Monday afternoon, 23 March (48hrs later), general practice had been transformed. Patients were contacted and advised that consultations would be by telephone, email or videoconference where possible.

That same day, two patients with COVID-19 were suspected to have been infected by community transmission, and New Zealand went to Level 3. Within 48 hours of that announcement New Zealand was in Level 4 lockdown. What happened in general practice is that the flow of patients into GP clinics just stopped. A combination of fear and anxiety about catching the virus encouraged people to stay at home in their bubble, and the perception that their general practices would be overwhelmed by COVID patients, meant that they also did not ring with their various concerns. General practice as we traditionally know it ended on 25 March 2020.

General practice is a conglomeration of small- and medium-sized businesses who operate almost entirely on cashflow. This is particularly true for those practices that are not Very Low Cost Access (VLCA) and so have a greater reliance on co-payments from patients. The switch to virtual consulting required setup costs including webcams, microphones, extra telephone lines and headsets. But at the same time, there was still a need to see patients for assessment of various symptom complexes, eg, chest or abdominal pain. However, patients stayed away, and did not contact their practices. Neither did they turn up at the emergency departments of hospitals, or accident and medical centres. It was as if there was nobody needing care.

What that meant for GPs is that cashflow dried up “overnight”. The number of consultations, whether virtual or in in person, plummeted by 50–80% within days. Suddenly general practices were in danger of becoming insolvent and not being able to meet their payroll requirements. The phones were still busy with staff (nurses and receptionists) fielding concerns regarding flu vaccines (that weren’t available) but nobody was wanting consultations.

Leaders in general practice, NZMA chief among them, met with the Ministry and the DHBs CEO representative, and agreed a rescue package for general practice for the duration of the Level 4 lockdown. There was also an injection of funding to general practices to recognise the initial costs of meeting the threat of COVID-19. This money was made almost immediately available to practices via the PHOs and relieved the pressure of insolvency for many.

It is now three weeks into lockdown and general practice is tangibly different. The waiting rooms are virtually empty, with a trickle of patients being seen for assessment or treatment. The CBACs are now up and running all over the country and have almost entirely taken over the assessment and treatment of COVID patients, apart from the occasional designated practice. Flu clinics are operating generally smoothly—patients drive up in their cars according to their appointment times (every 10 minutes) and are vaccinated while sitting in their cars, and then drive home to their bubbles. Bubble-sharers are vaccinated together; where individuals are vaccinated for the first time, they are asked to remain in the carpark for 20 minutes and toot their horn if they experience any reaction (none so far in my practice and we have now done over a thousand). Doctors are sitting in their offices, or in their homes working remotely, having significantly fewer (mainly virtual) consultations than previously.

Where have the patients gone? GPs are concerned that they are presenting later than they should out of concern for their own risk, and consideration for the health system. This consideration is misplaced—these patients still need to be “seen”—and the Ministry in the last few days have been saying this publicly. These patients may well resurface after lockdown has ended but with higher acuity, needing more urgent attention and even admission.

In order for the hospitals to be prepared for the potential influx of patients with COVID-19 elective surgery has all been put on hold and there have been no new first specialist appointments (FSAs) for the past four weeks. Those who had follow-up appointments and could be reviewed virtually have been, but the remainder have been deferred until after lockdown has ended and people can move more feely again. The real issue for general practice has been that many of those who had been referred for FSAs but had not yet been seen, have simply been returned to general practice. These are people with sufficient acuity and clinical need to be seen who have now just been declined, with a request to re-refer them if needed. This simply begs the question—either they needed to be seen or they didn’t. If they did, why then subsequently decline them? They could have been deferred and reinstated when clinics re-opened. Those who have had their elective surgery deferred will simply be getting worse and need more community care in order to manage, while waiting for their surgery post-lockdown. This kind of activity simply further increases the pressures on general practice at a time when it is already reeling under multiple pressures.

The frontline in New Zealand is not(yet) the hospitals and hospital doctors (they have not been inundated with COVID patients); it is the GPs and general practice. GPs have been faced with the most profound threat in COVID-19 to which they reacted swiftly, efficiently and effectively. They were then asked to make the most profound change to their way of working in the history of general practice in New Zealand, and did it over the course of a weekend. But these changes have taken an enormous toll on GPs, and general practice will never be the same again. GPs are anxious about their financial futures as consultation numbers are still significantly fewer than before lockdown. Contracted doctors are having their contracts ended or suspended, even though there is an expectation that consultation numbers will go up after lockdown has ended. Nursing staff have no guarantee of continued employment, and those staff at higher risk of COVID have had to be stood down. Managing the risk of exposure to COVID and the threat that represents to themselves, to staff and to their patients, needs to be managed on a daily basis.

General practices and the people who work there are the unsung heroes of this pandemic and need to be recognised for how they have responded to this challenge. In the weeks and months to come they will need the support of the rest of the medical community, and the public at large, for the outstanding effort that has been required of them to meet the COVID threat.

At the time of publication the Government has only paid $22m of the $45m support package promised to General Practice and the sector has been advised that the balance would not now be paid.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Kate Baddock, General Practitioner, Kawau Bay Health, Auckland.

Acknowledgements

Correspondence

Dr Kate Baddock, General Practitioner, Kawau Bay Health, Auckland.

Correspondence Email

kateb@kawaubayhealth.co.nz

Competing Interests

Nil.

Contact diana@nzma.org.nz
for the PDF of this article

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