Te Whatu Ora Health New Zealand is calling for primary care to fill in the gaps this winter as pressure ramps up at hospital emergency departments across the country.
That's despite general practices suffering from staff shortages and extended shifts, forcing them to close their books to new patients.
"I am really nervous for our members," Royal New Zealand College of General Practitioners president Samantha Murton said.
"There is flu coming through, Covid may rear its head again, and then there is the workforce shortage we have."
Te Whatu Ora says there will be significant challenges this winter, with major pressure on the emergency departments of eight hospital "hotspots".
They include Auckland City Hospital, Whangārei Hospital, Middlemore Hospital, Tauranga Hospital, Palmerston North Hospital, Wellington Regional Hospital, Christchurch Hospital and Southland Hospital.
The health body says primary care and pharmacies will have to assist over the colder months, and there will be more emphasis on telephone appointments.
Murton says the move runs the risk of general practitioners feeling they cannot do any more work.
"There is a risk that people who are nearly retired will retire early, and that people who see the workload will not join the team. That is critical," she said.
"You need to keep people who can train the newbies coming through, but we also we need to find some way of encouraging people to come to primary care."
That concern is shared by primary care nurses, who the New Zealand Nurses Organisation says are already at breaking point.
"They are exhausted, burnt out, picking up extra shifts, the cost of living is going up, they have rent to pay and food to put on the table," delegate Denise Moore said.
Moore, who is a registered nurse, says the fact that practice nurses haven't received a pay rise like their hospital counterparts means retention is difficult.
"They are thinking, 'If I can't get a pay rise in primary healthcare, I will go overseas or go work for Te Whatu Ora,'" she said.
"It is so bad now and I can't see it getting any better."
For Murton, the crisis across the primary care sector has been caused by historic failures to invest in health.
"We didn't train enough GPs for a long of time in the '90s and we don't have enough medical students come through who choose general practice," she said.
"We also don't have the nurses coming into primary care. We rely on immigrants coming into New Zealand, but lots of countries do. We need to grow our own talent."
Despite the strain, she says general practice doctors will do the extra work, but there needs to be an inclusive discussion about it.
"If you're going to have work going out in the sector, that sector needs to be involved in the decision-making."
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