In my copy of a yellowed newspaper clipping sits a bespectacled fellow engulfed in a tweed jacket much too big for him, under the headline ‘Locum’ retires after 68 years’.
“Dr Nicholls, aged 94, has run a single-handed practice at Meole Brace, Shrewsbury, during his entire professional life” reports the newspaper. “It is only bad arthritis in the knee which has finally forced him to put aside his stethoscope”.
I never met my great grandfather Albert, who qualified as a medical practitioner in 1909. The length of his career is astonishing for a doctor who practiced on his own, in a parish with a population of 2253 in 1931, according to Wikipedia. If Albert delivered a girl baby in 1911, she would have been drawing a pension by the time he hung up his doctor’s bag.
Albert, who described himself as a “true country doctor”, was divorced, did his own accounts and ran his business from the front room of his house. My aunt Jo remembers him playing the piano “with gusto” in the dining room between patients.
“The trouble with a single-handed practice is that you are on call 24 hours a day”, Albert told the journalist in 1980. “Now I will be able to spend more time gardening and writing music.”
Albert had six years of retirement, to garden and compose military band music; he died at the age of 100 in 1985.
His neighbourhood of Meole Brace no longer has a GP – Albert’s practice didn’t survive his retirement. “The price of housing here is so high it is unlikely that a young doctor would be able to afford to come here,” he told the paper.
The year Albert began working, general practice was a rough and dangerous trade. Treatments were limited; insulin wasn’t available until the 1920s, and penicillin not mass produced until WWII.
Today, many New Zealanders would welcome a visit from a GP on horseback, even one in his nineties. Aotearoa is critically short of healthcare workers; in the first eight months of 2023, 24 practices and clinics reduced hours or closed due to staff shortages and ‘cost pressures’. Over 60 percent of GPs say they can no longer take new patients, and people living in Northland, Gisborne and the West Coast have been hit hard. To access a doctor, many New Zealanders need to drive for hours and sit in an A&E waiting room for days. For people living in these areas who can barely afford rent, let alone a full tank of petrol, the New Zealand health system is unavailable.
As overworked and underpaid medical staff escape to countries with better pay and working conditions, those endured by staff who stay become, in a wretched feedback loop, even worse.
Waiheke Oranga Urgent After Hours care, to widespread shock, abruptly announced its closure two weeks ago, although thankfully the Waiheke Medical Centre (WMC) has announced it will be “stepping in [to] ensure continuity of care.”
While the Waiheke situation is complex, there is clearly no ‘fat’ to be cut in our national health system. We know this, because in order to pay for $10 billion worth of tax cuts for the richest 40 percent, the government’s gouging of public services has made things visibly worse.
The disabled, for example, are facing savage cuts to their support, changes which will in my opinion cost lives. “Freezing funding for disabled people,” as Bernard Hickey says, “includes banning new additional residential care places or spending, which means only disabled people who committed crimes, are insane or are stuck in a hospital bed can get in – and even then, they’re not guaranteed a place.”
Albert’s great-great grandson, my nephew Sam*, has inherited a permanent intellectual disability. “He was causing people around him injury; friends, family, strangers – anyone who was in the wrong place at the wrong time,” my sister told me. “We got to a point where we could not have anyone come to the house. Even a plumber’s visit took careful planning,” she says. “Now, six years on, our son is happily settled in residential care with skilled support workers. Aggressive incidents are rare. He visits us regularly. Everyone supporting him has a break, is trained in how to respond and no one has 24-hour responsibility for his care. Now we can do the things that people take for granted, like calling a plumber to fix a leak.”
For Sam and his family, residential care isn’t ‘fat’.
People like Sam who need to leave home after a crisis (for instance, after attacking a parent) are, research shows, more likely to require later intensive supported care. Medicine has undergone immense change since 1911, when Albert first walked through the door of his practice. But one thing hasn’t changed. Without the proper care at the right time, little things can get worse, and more expensive to treat. And sometimes, they can’t be fixed at all.
* Not his real name.
• Jenny Nicholls
© Waiheke Gulf News Ltd 2024
