Access to Services & Utilisation

Current Access

Access to general practice is variable across the different localities of Counties Manukau as outlined in the tables below.

The data suggests that Otara residents have some of the highest level of access to general practice as they have the highest number of GPs relative to their population, a high number of consults and they travel the shortest distance to the practice they are enrolled with. This contrasts to Botany/Clevedon whose resident have 3.5 times fewer GPs relative to their population, have fewer consults and tend to travel further to their practice (second only to Franklin).

Otara practices also appear to attract a number of residents from outside Otara with almost twice as many patients enrolled in Otara relative to its population.

Table 1: GP: Population ratios across Counties Manukau

	Raw Figures					Derived Figures
Suburb	No of GP Prac-tices	Enrolled Popu-lation	No of GPs (FTE)	No of GP Consults	2006 Census Projection	Enrolled Population per Usually Resident Population	Enrolled Population per FTE	Usually Resident Population per FTE	Consults Per Enrolled Population	Consults per Usually Resident Population
Botany/ Clevedon	3	7,729	6.3	3,392	23,077	33%	1,221	3,646	0.44	0.15
Franklin	5	40,773	24.8	30,230	60,771	67%	1,644	2,450	0.74	0.50
Howick/ Pakuranga	25	82,721	54.2	27,217	96,063	86%	1,526	1,772	0.33	0.28
Mangere	13	54,605	40.8	39,783	52,637	104%	1,338	1,290	0.73	0.76
Manukau	10	41,708	23.8	30,607	34,694	120%	1,749	1,455	0.73	0.88
Manurewa	11	35,354	23.4	22,763	59,555	59%	1,513	2,549	0.64	0.38
Otara	7	65,651	31.3	67,357	32,981	199%	2,096	1,053	1.03	2.04
Papakura	16	48,343	30.6	34,380	47,000	103%	1,582	1,538	0.71	0.73
Papatoetoe	11	29,011	22.2	21,161	47,318	61%	1,307	2,131	0.73	0.45
Total/ Average	112	461,221	284.2	317,872	454,096	89%	1,623	1,764	0.69	0,61

Source: 2006 PHO Enrolment data
Note: This data does not include patients who are not enrolled with a practice/PHO.

The residents of Botany/Clevedon and Papatoetoe are more likely to enrol with a practice outside their locality of residence than other localities. The residents of Botany/Clevedon enrolling outside their locality tend to enrol with a general practice in Howick/Pakuranga or in the Auckland District Health Board area. A high proportion of residents in Papatoetoe enrol with practices in the Auckland District Health Board area and in the immediate surrounding suburbs of Otara and Mangere.

Overall, Counties Manukau residents tend to enrol with a general practice within a few kilometres. Fifty percent of all Counties residents travel less than 2.63 kilometres to the general practice they are enrolled with and 75% travel less than 5.6kms. As expected the distances are greater in the more rural areas of Franklin and Clevedon and lowest in areas of practice concentration such as Otara.

Table 3: Distance (in kilometres) between a patient’s place of residence and their choice of enrolment

Future Access

With such large increases in population, general practice will need to grow and adapt.

If we continue with the current model of general practice and configuration, we will need an extra 100 GPs over the next 20 years. That equates to an additional 40 current size practices[4] or a new practice every 6 months. This is to maintain the current low access ratio of ~1,700[5] enrollees for every GP.

If Counties was to actively move to the NZ average GP to enrolee ratio of 1,300, it would need an additional 40 practices – the equivalent of a new current size practice every 3 months.

There have been some new practices emerge to replace older ones or as a merger of existing practices, but the number of new de novo practices that have opened in the Counties Manukau district in the last 5 years has been two - one in Mangere within the Airport complex and one within Mangere itself. That is despite similar levels of growth in the last 10 years to that predicted into the next 20.

The highest areas of growth that appears to be required are in Manurewa and Botany/Clevedon which both have poorer access relative to other localities now and have the highest predicted level of growth.

[4] The current average practice size is 2.5FTE GPs
[5] An approximate of the number of FTE per enrolled population and the number of FTEs per resident population.

About Counties Manukau District Health Board

Current Access

Future Access