Recent trends in the availability, distribution, utilisation and cost of general practitioner services.

GMS data for the 1983-4 and 1986-7 years were analysed to determine the availability, distribution and utilisation of general practitioners in New Zealand. In 1986-7 there were 1724 full time equivalents (FTE) general practitioners, one per 1923 population, an annual increase in availability of 2.8% over the three years studied. The rate of availability appears to be increasing rapidly and, from Medical Council data, was around 6% for the 1986-7 year. Wide variation exists in availability, the highest being in central Auckland with one general practitioner per 1351 population, the lowest being in Invercargill with one per 2500. Utilisation increased by just over 1% annually to 3.9 services per person. The median workload in 1986-7 was 7184 services per general practitioner equivalent to a GMS income of $31,454. Each general practitioner was associated with government expenditure of about $359,000 but received only about $33,670 of this, less than one seventh of that paid by government for pharmaceuticals. Radical changes are proposed to redress inefficiencies, inequities and the perverse incentives which continue to increase in this almost totally unmanaged but fundamentally important area of health care.