-
Business valuations
We offer expert valuation advice in transactions, regulatory and administrative matters, and…
-
Capital markets
You need corporate finance specialists experienced in international capital markets on…
-
Complex and international services
Our experience of multi-jurisdictional insolvencies coupled with our international reputation allows us…
-
Corporate insolvency
Our corporate investigation and recovery teams can help you manage insolvency situations and…
-
Debt advisory
An optimal funding structure for your organisation presents unprecedented opportunities, but…
-
Expert witness
Our expert witnesses analyse, interpret, summarise and present complex financial and…
-
Financial models
A sound financial model will help you understand the impact of your decisions before you make them.…
-
Forensic and investigation services
We provide investigative accounting and litigation support services for commercial, matrimonial, criminal,…
-
Independent business review
Is your business viable? Will it remain viable in the future? A thorough independent business review can…
-
IT forensics
Effective ESI analysis is integral to the success of your business. Our IT forensics experts have the…
-
Mergers and acquisitions
Grant Thornton provides strategic and execution support for mergers, acquisitions, sales and fundraising.
-
Raising finance
Raising finance - funders value partners who can deliver a robust financial model, a sound business…
-
Relationship property services
Grant Thornton offers high quality independent advice on the many financial issues associated with…
-
Restructuring and turnaround
Grant Thornton’s restructuring and turnaround service capabilities include cash flow, liquidity…
-
Transaction advisory
Our depth of market knowledge will steer you through the transaction process. Grant Thornton’s dynamic…
-
Virtual asset advisory
Helping you navigate the world of virtual currencies and decentralised financial systems.
-
Corporate tax
Grant Thornton can identify tax issues, risks and opportunities in your organisation and implement…
-
Employment tax
Grant Thornton’s advisers can help you with PAYE (payroll tax), Kiwisaver, fringe benefits tax (FBT), student…
-
Global mobility services
Our team can help expatriates and their employers deal with tax and employment matters both in New…
-
GST
GST has the potential to become a minefield and can be expensive when it goes wrong. Our technical…
-
International tax
International tax rules are undergoing their biggest change in a generation. Tax authorities around…
-
Research and Development
R&D tax incentives are often underused and misunderstood – is your business maximising…
-
Tax compliance
Our advisers help clients manage the critical issue of compliance across accountancy regulations,…
-
Tax governance
Mitigate tax risks and implement best practice governance that will stand up to IRD scrutiny and audits.
-
Transfer pricing
Tax authorities are demanding transparency in international arrangements. We businesses…
-
Audit methodology
Our five step audit methodology offers a high quality service wherever you are in the world and…
-
Audit technology
We apply our audit methodology with an integrated set of software tools known as the Voyager suite. Our…
-
Financial reporting advisory
Our financial reporting advisers have the expertise to help you deal with the constantly evolving regulatory…
-
Business architecture
Our business architects help businesses with disruptive conditions, business expansion and…
-
Cloud services
Leverage the cloud to keep your data safe, operate more efficiently, reduce costs and create a better…
-
Internal audit
Our internal audits deliver independent assurance over key controls within your riskiest…
-
IT advisory
Our hands on product experience, extensive functional knowledge and industry insights help clients solve…
-
IT privacy and security
IT privacy and security should support your business strategy. Our pragmatic approach focuses on…
-
Payroll assurance
Our specialist payroll assurance team can conduct a review of your payroll system configuration and…
-
PCI DSS
Our information security specialists are approved Qualified Security Assessors (QSAs) that have been…
-
Process improvement
As your organisation grows in size and complexity, processes that were once enabling often become…
-
Procurement/supply chain
Procurement and supply chain inputs will often dominate your balance sheet and constantly evolve for…
-
Project assurance
Major programmes and projects expose you to significant financial and reputational risk throughout…
-
Risk management
We understand that growing companies need to establish robust internal controls, and use…
-
Robotic process automation (RPA)
RPA is emerging as the most sophisticated form of automation used to help businesses become…
Funding to train more general practitioners is top of the Budget wish list for Pam Newlove, Business Advisory Partner. Why? Because our GP workforce is in crisis.
Half our GPs are nearing retirement, we don’t have enough graduate GPs, and demand is only increasing, according to the Royal New Zealand College of General Practitioners (RNZCGP).
Demand is growing, supply is falling
Our aging population and changing models of care is increasing demand for general practitioners. According to the 2020 Health and Disability System Review, there is a trend toward moving healthcare from the secondary sector to the primary sector, which helps improve equity of care for vulnerable and underrepresented populations. Yet, while the demand for GPs rises, the population of GPs is being squeezed at both ends.
First, they’re retiring at a rapid rate, with 50% of all GPs saying they’re planning to retire over the next 10 years. The pandemic has brought forward that retirement decision for many people in primary care, as they’ve struggled with a lack of support and recognition.
The number of GPs per 100,000 New Zealanders is projected to fall from 74 to 70 over the decade, according to the 2021 GP Future Workforce Retirement Report. That does not compare favourably with Australia’s 116 GPs per 100,000.
Second, we’re training too few GPs. New Zealand enrolled 2,876 medical students in 2021 at our two medical schools, according to Medical Deans research. In comparison, Australia’s 21 medical schools enrolled 18,157 people in 2021. Australia has five times our population, but it’s training more than six times as many doctors. We lose a reasonable number of potential medical students to Australia too – when there isn’t room for them at our medical schools in Otago or Auckland, they often enrol in Australian schools and some ultimately decide to live and practice there.
Crunching the numbers: More funding is needed to train 50% more GPs each year, but the payoff is massive
Our current training intake for GPs is 200 a year, and we need at least 300 a year to meet the forecast shortfall. To support this additional number of trainees, universities need some extra funding, and an extra 100 general practices should be incentivised to take on first-year registrars. The time and cost for these incentives are significant, but the return on investment will be substantial.
Calculations by the RNZCGP estimate the extra GPs would generate a net benefit to our economy of $139.6 million, after deducting the $10.4 million it would cost to train them. For every dollar spent on training a GP, we’d get $4 in national benefits. To put it in a more human context, an extra 10 GPs per 100,000 Kiwis would mean an estimated 30 fewer deaths each year from cancer, respiratory, and cardiovascular issues. Training more GPs would also help us develop a more diverse GP workforce, which has been shown to materially improve health equity.
Money versus flexibility and community connections
We also need to do more to show medical students the upsides of choosing to be in primary care rather than specialising. Money is a factor – GPs make perhaps 40% less than specialists when they graduate, and that’s a strong disincentive. It would be good to see that change.
It’s not all about the money, though. There are some major upsides to being a GP, particularly in terms of flexibility, community connections and work-life balance. The value of these factors is hard to quantify, but to be able to appreciate the benefits, students need exposure to opportunities in primary care, particularly in rural communities where our GP shortage is the most severe. We need to incentivise general practices to take on registrars, which may mean more funding to compensate for the time and money they invest in training new GPs.
GPs also make a huge difference to national health, and not only as first points of connection to the healthcare system. This has been clearly evident throughout pandemic, where GP practices delivered around a quarter of covid vaccines and demonstrated their ability to pivot into e-prescribing and online consultations. As our healthcare model pushes more work onto the primary care sector, this influence is set to rise even further. Yet right now it’s already difficult for many people to get an appointment to see their GP; as our shortage worsens, this problem will only become more acute.
Primary healthcare cannot be left behind in yet another Budget.
If we invest in primary care, every New Zealander will experience the benefits. We all understand you can’t fix the entire healthcare system by simply throwing money at it, but in Budget after Budget primary care is left behind. GPs and their practices are left trying to deliver more services to more people with fewer resources - both financial and human. It’s an issue that’s been a blot on the healthcare horizon for years. We’re hurtling towards that horizon at speed. The blot is getting bigger. The time for action was yesterday.