A Critical Missing Ingredient

More dietitians needed in primary health care to ease the burden of preventable diseases on a health system at breaking point

- For every $1 spent on funding dietitians in primary health care, the country will see a cost saving benefit of $99 over five years
- Up to 24% of GP visits are nutrition-related and could be covered by a dietitian to relieve pressure on the strained GP sector
- More dietitians in an equitable and collaborative primary health care setting are required to meet the growing burden of preventable disease on the population

A first of its kind report in New Zealand found an overwhelming need to include more dietitians in primary health care, with every $1 spent on funding dietitians estimated to deliver a cost-saving benefit to the country of $99 over five years.

Dietitians NZ, the professional association for registered dietitians, is urging the Government to invest in primary health care dietitians as part of the recent health sector reform announcements.

With type 2 diabetes alone expected to cost the health system $3.5 billion in two decades, early dietary education to prevent onset and reduce complications of preventable diseases is crucial. Just 6% of dietitians are currently employed in the primary health care setting and Dietitians NZ is calling for this to change.

The report found that dietitians could share the burden of work currently overloading GPs across the country, with 16-24% of GP visits able to be covered by a dietitian instead. Including dietitians in multi-disciplinary teams would not only help reduce GP workloads, but may also address the longer-term shortage of GPs.

Undertaken by New Zealand Institute of Economic Research (NZIER), the report set out to determine the value of dietitians as part of a holistic approach to preventative health care, focussing on three major health conditions in the context of primary health care: diabetes, cancer and mental health.

With dietitians being the experts in providing nutrition care in NZ, it begs the question why funding is currently only allocated for dietitians to act as the ‘ambulance at the bottom of the cliff’ in hospitals, whereas a ‘top of the cliff’ preventative approach in primary health care is needed.

“In New Zealand there is a ratio of just 9.6 practicing dietitians per 100,000 people and this is 30% lower than Australia, Canada, the UK and the USA,” says Kath Eastwood, CEO of Dietitians NZ.

“We are excited to see a shift in focus towards prevention and primary health care as part of the health reforms announced by Minister Little, and our report is evidence of the important, cost-effective role dietitians will play in this.

“The establishment of the Māori Health Authority shows a serious commitment to equity, and we need to accelerate the recruitment and training of Māori health professionals to restore tino rangatiratanga for Māori by Māori and ensure a culturally safe workforce so that Māori dietitians can thrive. Inequities in health disadvantage Māori leading to higher rates of cancer, diabetes and mental health conditions, but only 4.1% of the current dietetic workforce whakapapa to the whenua of Aotearoa.”

General Practice New Zealand has long advocated for a re-structuring of the health system and hopes the findings of the report will be reflected in the rollout of the recent health reform announcements.

“The transformation of primary health care will be critical. There must be a focus on prevention in a model of care that incorporates lifestyle factors such as diet to prevent reliance on secondary care in hospitals,” says chair Dr Jeff Lowe.

With good nutrition underpinning so many health conditions and evidence supporting the benefits for patients, communities and service providers, dietitians are ready to be part of transformative change in our health sector.

View the Report here