But the SDHB’s chief medical officer, Dr Nigel Millar, said consultation for the proposal was not yet complete, and the new model was vital to better cater for Otago’s growing and ageing population.
Also, WellSouth Primary Health Network chairman Dr Douglas Hill says there has been "strong input" from the primary care sector, including patients and clinicians and there is "generally broad support for the direction the strategy is going".
Dr Greg White, of Cromwell Family Practice, said there was "no proof" the proposed changes would make any difference to the SDHB’s budget or patients.
The SDHB itself had said it was "unlikely to receive an increase in budget" for any new model, Dr White said. He said the SDHB was trying to "shift the burden (or blame perhaps)" to GPs and patients to reduce its deficit, and "soften the blow" if fewer beds were built in the new Dunedin Hospital.
Dr White has previously said he understood there would be a 30% reduction of beds in the new hospital in some departments.
However, Dr Millar said that that was a "misunderstanding" that was circulating.
The new hospital would in fact have more beds than it did at present, but that number would be 30% fewer than what the bed increase would have been if the existing model of healthcare was continued.
The DHB’s draft primary and community strategy and the accompanying action plan — released earlier this month — further outlined a plan announced in October to shift more healthcare into the primary sector and develop a "hub and spoke" model of shared care.
Dr White said there were some positives in the proposals, including discouraging attendance at emergency departments, and making primary care the gateway to the health system.
But he said "this [primary care gateway] is already largely the case, and will not magically improve the SDHB budget to any extent". And rural hospitals already acted as "hubs", as proposed by the SDHB, he said.
Dr White was sceptical of the SDHB’s desire to further empower consumers to better selfcare.
"Sounds like a great idea. Most people would if they could. But the frail elderly, the mentally unwell, the addicted, and children have little such ability."
He was also concerned about "an implication" rural hospitals would house primary care clinics, and about the economics of looking after more people in their own homes.
"A large part of the plan seems to be to keep people in their homes or in rest-homes rather than be admitted to hospital. Sounds great, but [it] is prohibitively expensive to have one nurse looking after one person at home overnight, hence, hospital wards."
Dr Millar said New Zealand’s excellent primary healthcare was the reason it had such a successful health system, and reshaping the primary healthcare model would see enhanced capability.
It was "not about making GPs work harder", but about reshaping how primary care was organised.
When asked about the difficulty of attracting any more GPs to Central Otago that might be needed, when it was already difficult to attract GPs to rural areas, Dr Millar said he hoped the new model would make general practice more attractive to those in the medical profession.
He said there had been one round of meetings with clinicians about the new healthcare strategy last year, and a second round last week. More consultation was still to be held, including a round of public meetings around Otago and Southland next week.Dr Hill said there had been "a great deal of interest" from GPs in the sessions last week.
