Royal New Zealand College of General Practitioners

I begin by greeting everyone in the languages of the realm of New Zealand, in English, Māori, Cook Island Māori, Niuean, Tokelauan and New Zealand Sign Language. Greetings, Kia Ora, Kia Orana, Fakalofa Lahi Atu, Taloha Ni and as it is the afternoon (Sign)

I then specifically greet you: Dr Harry Pert, President of the Royal New Zealand College of General Practitioners and your chief executive Karen Thomas; Dr Iona Heath, President of the Royal College of General Practitioners; Dr Chris Mitchell, President of the Royal Australian College of General Practitioners and your chief executive Dr Zena Burgess; Dr Ram Raju, President of the Fiji College of General Practitioners; Distinguished Guests otherwise; Ladies and Gentlemen.

Thank you for inviting me to the graduation ceremony of the Royal New Zealand College of General Practitioners.  As Patron of the College, I would like to take this opportunity to speak of the importance of your work and the significance of graduating as a Fellow of the College.

At the outset, may I offer the apologies of my wife Susan who is unable to be here today.  With the birth of our third grandchild, she has decided to stay in Wellington to support our daughter.

While my career has had strong legal thread—as a lawyer, Judge, Ombudsman and now Governor-General—the work of those in the health sector has always been close at hand. 

A fundamental waypoint is that my parents were both health practitioners—my mother was a Karitane nurse and my father was a general practitioner.  My father in fact joined the College in 1974, not long after it was established as an entity separate from the British College in 1973.  Our family has fond memories of his graduation as a Fellow of the College in 1990.

Given that background, throughout my career I have had the opportunity to remain connected with many contemporary medico-legal matters.  One example is the 16 months I spent chairing, at the Government's request, the Confidential Forum for Former In Patients of Psychiatric Hospitals.

Since being appointed Governor-General in August 2006, Susan and I have also agreed to be Patrons of a number of organisations that actively work in the health sector.  In addition to this College, I am also Patron of the Royal Australasian College of Dental Surgeons, the Royal Australian and New Zealand College of Psychiatrists, the Plunket Society, the AIDS, Heart, Kidney and Asthma Foundations, to name but a few.  On reflection, I suspect there are few parts of the body or its maladies that are not covered by Governor-General patronage!  But I jest!

Having, hopefully, established a place to stand before you, I want to emphasise the importance of the work you do.  I am well aware that there are some who look down on the work of general practitioners.  The question sometimes still posed to young graduates which goes:-—“Are you going to be a specialist or just a GP?”—verges on the insulting. 

The reality is that general practitioners and others working in primary healthcare are the foundation of our health system. If one was to use the analogy of the fence at the top of the cliff, I believe that GPs are the posts and concrete that hold it in place. Without the work that you do, that of those in secondary and tertiary care—the ambulances at the bottom of the cliff—would quickly become overwhelmed.

For the majority of New Zealanders, their GP will be their main connection with the health system throughout their lives.  Unlike a specialist or surgeon, who they may rarely, if ever need to visit, a GP is someone they come to know and trust.  That trust extends beyond their physical health but also includes being a guardian of highly sensitive personal and family information.

It is with good reason that when The  Reader’s Digest  undertook its annual survey of the professions New Zealanders trust, that doctors, along with nurses, firefighters and ambulance officers, were the among top five most trusted professional groups in 2010.

The standing of doctors, and particularly general practitioners, rests on the bonds you build with the people you see in your practices everyday and the bonds which you build in your communities.   That GPs who stand for election to councils or school or health boards are often elected reflects wider community respect and the strength of your connections with the communities in which you live and work.

A commitment to general practice is a commitment to more than working 9 to 5.   There are after-hours responsibilities and, particularly for those working in rural areas, there is also assistance required at accidents and other emergencies when a specialist can often be a lengthy helicopter flight away.

The diverse knowledge and skills required to be a general practitioner and the ever increasing volume of new medicines, treatments and information available requires constant education and engagement. 

That is where membership, and particularly fellowship, of the Royal New Zealand College of General Practitioners is so important.  Fellowship of this College—the first specifically New Zealand College in any medical discipline—signifies your commitment to ongoing learning. 

While the postnominal letters “FRNZCGP” on the nameplate outside your office may mean little enough to people whom you treat everyday, they signify your commitment to enhanced standards of patient care and quality.  That the overwhelming majority of general practitioners are associates, members or fellows of the College signifies its standing in the profession and the quality of its rigorous and lengthy postgraduate programme.

To the Fellows graduating here today, I congratulate you on your commitment to your profession, the people under your care and to the wider community.  In summarising the value of the work you do, I will close with a quote from my predecessor, Sir John Charles Lyttelton, the 10th Viscount Cobham, who addressed a Medical Association gathering in this city of Christchurch in 1959.  While we will need to forgive the masculine language used, the general points remain valid 51 years later.  He said:

“For the crux of all human problems is the human element, and so long as the flesh is heir to its multiple ailments, just so long will the doctor and the nurse be found in the forefront of the battle.  The battle is fiercer for the doctor today than ever before.  The increasing complexity of civilisation has been matched by an ever-increasing number of new challenges to his ingenuity and skill …. From time immemorial the most honoured man in his tribe has been the medicine man.  I have a shrewd suspicion that his more civilised counterpart is almost equally adept at spotting the evildoer in addition to healing him; but like those of the priest, his lips are sealed.”

And on that note – prefacing the imminent sealing of my own lips – I will close in New Zealand’s first language Māori, by offering everyone greetings and wishing you all good health and fortitude in your endeavours.  No reira, tēnā koutou, tēnā koutou, kia ora, kia kaha, tēnā koutou katoa.