A rural Bay of Plenty town is struggling so much to attract doctors, that its only GP is flying in unvaccinated South Island locums who can't find work elsewhere.
Bernard Conlon is currently the sole doctor at Murupara Medical Centre, and says he cannot get anyone from the region to come and work in the isolated town.
While some parts of the country were experiencing wait times for appointments of up to four weeks, in Murupara, Dr Conlon saw non-urgent patients within one or two days.
However, the prompt service came with the risk of the town's only doctor burning out.
Dr Conlon made himself available on-call 24/7 and often made home visits 60 kilometres away.
On top of his regular clinic hours, he attended after-hours callouts about three nights a week, and saw patients in the weekend.
"It would probably be easier to say how many hours I'm not working," Conlon said.
Until 2021, Murupara had four doctors.
Two of them left when the government mandated Covid-19 vaccinations for health professionals; Dr Conlon's own public questions about the vaccines caused him to be suspended by the Medical Council for four months last year.
With Dr Conlon's wife - also a GP - currently overseas, he had sought help from locums in the area.
But with the nearest city, Rotorua, 45 minutes away, he said doctors were unwilling to make the journey.
"Ability to access locums is very competitive and a rural general practice is at the back of the queue.
"For a variety of reasons, the majority of locums are not interested in covering rural practices, but choose to stay in urban areas for convenience, for access of other amenities, so it's a pretty redundant reality looking for locums in the vicinity."
It forced Dr Conlon to look further afield - as far away as the South Island - where he found two unvaccinated GPs who were looking to return to the post-mandate workforce but who had not been able to secure jobs.
He flew them up as often as they were willing to come, paying for their flights, which could cost $900 a trip.
But he said the cost was worth it, as it meant that roughly three weeks a month, he had a second pair of hands on deck.
Without this inter-island assistance, he said he would not be able to cope.
"For health reasons, my wife has had to shoot across to London and will be there for the foreseeable future, so that leaves just myself trying to manage and coordinate the care of nearly 4000 patients.
"The workload is such that it would be unmanageable."
One of the doctors flying up from Southland, who Checkpoint agreed not to name, had not been able to land a job locally since the Covid-19 mandates.
She said while it was not an ideal situation, she had little option but to travel the hundreds of kilometres to work.
"I have no choice; I have to feed my family and I can't get a job locally.
"It's really hard being away from my family, and it's hard working busy days, but I guess that's what it is."
She helped Dr Conlon with the full range of urgent and non-urgent work, allowing him to take some much-needed time off - or get out to his satellite clinic in Kaingaroa.
Working in Murupara two weeks out of every six, she did not know how Dr Conlon managed the rest of the time.
"The whole town has his address and cell phone number; they just turn up in his driveway if they need something done after hours.
"He gets up at about four or five in the morning to start checking his blood results and doing repeat prescriptions.
"He will often do home visits for palliative patients on the way to and from work, in addition to doing an entire day's work and often not even being able to stop for lunch."
Lakes territory manager for St John George Clicquot said he was aware of Murupara's critical health shortages.
"Murupara is definitely not alone in terms of the feedback that we get from lots of rural spaces about wanting more comprehensive access to primary healthcare."
Clicquot said the town had 12 first responders who acted as St John's eyes and ears on the ground.
They were trained to assess the urgency of a situation and managed some events like cardiac arrests until paramedics arrived.
Because of Murupara's distance from the nearest hospital, Clicquot said sometimes, the best response to a medical event was taking the patient to the local medical centre.
But that all added to the workload of Dr Conlon.
While he was working the job of at least two doctors for now, he was approaching retirement age, and worried what would happen in Murupara when he eventually hung up his stethoscope.
"I've seen the calibre of young docs coming through, and I would have to say the vast majority would look at my workload and just would not tolerate that level of intrusion."
Rural areas a priority
In a statement, Te Whatu Ora acknowledged the current workforce pressures throughout the health system, and said rural communities were a priority area for recruitment.
Acting group manager for primary healthcare system improvement Toni Atkinson said Te Whatu Ora and the Māori Health Authority were working to develop a rural clinical telehealth service.
"This service will continue to prioritise high-need populations to improve access to care, in particular Māori, Pacific peoples, and those with disabilities, tāngata whaikaha Māori, living rurally."
Te Whatu Ora was working with the Royal New Zealand College of General Practitioners to strengthen the GP training pathway, increasing the number of GPs trained annually from 200 to 300 by 2026.
A $9100 accommodation allowance would be provided for General Practice Education Programme trainees who lived within 30km of their rural general practice.
RNZ
