Kia ora tātou

Well, winter has finally arrived! Snow on the mountains (too late, unfortunately, for families in the school holidays), hoar frosts in the inland areas of both main islands, and even frosts in Wellington!

This is all a far cry from the heatwaves I have just returned from in France. 42 degrees is pretty hot to cycle around various Chateau and vineyards in the South of France, but bearable with routes that incorporated rivers, lakes and the Mediterranean, where complete immersion prevented heat stroke. Going walking in the high Alps behind Chamonix and Lake Annecy also resulted in acceptable temperatures, but observing the massive glacial retreat on the slopes of Mt Blanc and Les Drus since my last visit several decades ago was devastating. I managed to time my exit back to NZ before the wildfires started springing up all across France, Spain and other European countries.

Meanwhile, back in NZ the effects of global warming have been just as evident in a different way. Localised flooding events now seem to be almost weekly as the warmer atmosphere holds more moisture and then drops it in short periods of time in our regions. Kaikōura was the latest area to suffer, with SH1 roading cut off both north and south of the town. Well done to the team at Kaikōura Hospital and Healthcare Centre who managed the crisis and supported the local pharmacy, which was impacted by the floods, for the benefit of the local community and out-of-town visitors. Amazing resilience shown by the whole team, especially in the aftermath of recent earthquakes. Lessons from these events just reinforce the need for whole community planning in advance of major events.

The prediction of a developing El Niño weather pattern for the summer means that we can expect increased West Coast rainfall this summer and drought conditions in the East and North. Our rural communities are likely to be the hardest hit yet again, and I am sure there is plenty of planning occurring right now.

The reason for going to France was not just to escape the long nights / short days of a NZ winter, but to attend the 30th WONCA Europe Conference 2026. Held over four days a few minutes walk from the Champs-Élysées and Arc de Triomphe, the conference attracted over 4000 delegates from countries around the world. Along with my work colleague Amanda, we were there to try to attract trained doctors and nurses to New Zealand. Our stand had a constant stream of curious and interested people who had either visited NZ on holiday or who had strong impressions of the amazing landscape and friendly people there. We had been helped in our promotion through movies such as The Lord of the Rings and The Chronicles of Narnia. We came away with a strong list of potential clinicians that our team will continue to engage with to get them to NZ in the next few years. Thanks to those NZ doctors, and the international doctors who had worked in NZ, who dropped by our stand for a chat and spoke so positively about NZ to the people there to enquire about a working pathway.

Back in New Zealand, the constant change in our health systems, workforce shortages and funding arrangements continue to add pressure. The movement around PHOs, without a clear Government Policy on future direction, has only exacerbated stress in some areas. I was fortunate to be chosen as one of four representatives of contracted providers (General Practice Owners) to work with representatives of PHOs and Māori PHOs to negotiate with Health NZ about the 26/27 funding levels for PHOs and practices set through the PSAAP agreement. Can I commend the work of all people involved in these negotiations. Everyone in the negotiations was respectful and considered, even though there was regular disagreement. The amount of work in preparing for the meetings, writing and interpreting complex papers and issues, and then meeting weekly (sometimes in person for full days) was a massive commitment. Getting re-weighted capitation implemented, while managing as well as possible those who suffered through the redistribution of a finite funding pool, was an issue the sector had been seeking for a long time. Not including ethnicity in the calculations was regularly decried by the negotiating team, but had been taken off the table for these negotiations through a Cabinet Decision from the coalition Government. There is a commitment to revisit the capitation formula in two years, which provides the next opportunity to include this key factor.

The next big challenge for the rural sector is to arrive at an acceptable formula for the distribution of rural funding. A working group is currently being formed to guide work on this, and our hope is that at key points in the discussions, we can go to the rural sector for advice and feedback on the best ways to proceed, and what factors are critical to weight in any formula so that the funding ends up where it is most needed. Once again, there is a fixed funding envelope, so any redistribution will result in funding changes for practices. The challenge is to look at, and agree on, the principles of funding need; rather than the impact on any particular practice. We are arguing strongly for the ability of the working group to share information with the rural sector at key points in the discussion. We are also working to ensure that funding allocations to rural practices contracted to offer urgent, unplanned care services, can be known in advance. In this way practices can be aware of the total impact they will see, due to all of the main funding streams that are likely to affect them, in the 27/28 financial year.

I look forward to catching up with many of you at the upcoming GP26 Conference in Auckland.

Take care and welcome to the longer days that are now starting to smile on us.

Ngā mihi

Grant

JULY NEWSLETTER – CLICK HERE TO READ