A Northland doctor says no political parties are going far enough to tackle problems in the health system, and their debates are like "seagulls fighting over the last chip".
Whangārei GP Geoff Cunningham said the region was experiencing a major workforce shortage with about 25,000 people not registered with a GP, and that he has not seen any politicians properly addressing a "beyond broken funding model".
"We've struggled to recruit and retain GPs up here," he said.
"GPs will earn a lot less in Northland for working a hell of a lot harder than they will for working in cities.
"General practice has to have attractive conditions and remunerations to have people want to specialise... It's a 12-year training to become a general practitioner
He said there was little comfort from listening to politicians attempting to address the issue.
He described hearing Labour's Ayesha Verrall and National's Simeon Brown on Wednesday's Morning Report health debate as "like listening to two seagulls fighting over the last chip".
During the debate Verrall confirmed Labour would keep the coalition government's health targets if elected, while admitting some of its "three free GP visits" could be with a nurse practitioner rather than a GP.
She said the party would introduce "efficiency improvements" such as a triaging system to reduce acute demand.
Brown said Labour's policy was going to "clog up" the health system.
He called on Labour to produce its modelling which supposedly showed how it would free up four and a-half million appointments. He said if that did not happen the health system would be overrun.
Meanwhile, Brown claimed the country's health system was "heading in the right direction".
He highlighted the new Waikato Medical School which is set to train another 120 doctors per year, with the first cohort entering in 2028.
One of Cunningham's concerns was the push for a non-doctor workforce.
He said while this was being sold as a way to assist GPs, it raised some safety issues.
Association of Salaried Medical Specialists head Sarah Dalton told Morning Report no one was speaking in a "meaningful way" about the medical workforce in terms of specialist doctors including GPs.
"If we want a health system that is responsive and safe, it needs to continue to be led and staffed by senior doctors and dentists."
"... I think the focus on non-doctor healthcare is more about cost-cutting and a refusal to engage in the challenges of recruiting to hard-to-staff areas rather than what's best for patients."
Dalton said while it was great that more doctors where to be trained at Waikato Medical School, the results from this would not be felt for another 10 to 15 years.
She said some points went to Labour for focusing on acute flow in their policy,
"We would argue that the targets that focus specifically on planned care and first specialist appointments are incentivising and, in fact, forcing hospitals to focus on those things at the expense of acute care and on follow-up appointments"
"So patients with chronic medical conditions, particularly those who rely on the care of physicians, combinations of medications, monitoring over time, mental health patients who need regular contact with psychiatrists and their teams, are missing out through this focus on first specialist appointments."
On discussions around AI freeing up time for GPs, Cunningham said the technology was not "the great panacea for general practice".
"It's just a dictation service, really, for note-taking... it might just get you out the door at the end of the day, probably about 10 minutes sooner."
He said a more successful model would be to triage patients at a clinic in the morning. This includes phoning patients to see if problems can be solved without an in-person appointments.
"That has a pretty high success rate more so than telehealth, because obviously we know the patients, we have the notes there, but often patients are phoning merely for some pretty easy things."
