Rural Waikato GP named 2018 Peter Snow Memorial Award recipient

Long-serving Te Kuiti GP Dr Keith Buswell is the recipient of the 2018 Peter Snow Memorial Award. The accolade was announced at a ceremony at the New Zealand Rural General Practice Network’s annual conference in Auckland on April 7. Dr Buswell has been a rural GP in Te Kuiti for more than 30 years and was presented with the award by last year’s recipients Dr Chris Henry and Dr Andrea Judd, both from Kaikoura.

Dr Buswell was nominated for his “Innovation and Service to rural health”.

His nomination citation said: “Keith has always been willing to support rural health research and has participated in studies on prostate cancer, a survey of mental health, diabetes and heart studies. Overall he has proved an innovator, a leader and a teacher whose contribution to his community, to the Waikato and nationally has been immense – and yet has been hidden due to his self-effacing nature and natural tendency to put others first.”

“Through Keith’s leadership general practice in Te Kuiti is now held up as a model of integrated, community engaged rural general practice.

Dr Buswell said the award was a “bolt out of the blue”. “I feel very honoured to be included in the group of rural general practitioners who have received this award before me. Each of them
have made huge contributions to rural health.

“I’d like to acknowledge the role of my wife and GP Elly Kroef in all of this. We used to job share in the early days from about 1986 until the last of our children went to school. That’s how it all started. There were also a number of other GPs in town including John Earwaker and Mike Miskelly and we teamed up to form a group practice back in 1993-4.

“I’m delighted I have to have been able to form what has been a type of practice seen as innovative and a combination of primary and secondary care in a rural town. It shows the two
can blend together in a rural setting.

“It’s also been satisfying seeing GPs able to work at a higher level, at hospital practice level and with the clinical decision-making required at that level.

“It’s a reflection of what all rural GPs do every day, except in our situation it’s a little more formalised.”

Dr Buswell says the variety of medicine is the essence of rural general practice and rural practice offers the opportunity to go on learning and to add to your skills every day. It also offers the opportunity to become closely involved in the community you work in, which is very rewarding in itself.

“I see rural general practice as a viable thing in the future and more challenging than its urban counterpart which I believe has a narrower scope of practice.”


In 1994 Keith worked with the then Waikato Crown Health Enterprise in setting up a comprehensive primary care practice based on the Te Kuiti hospital site. There are four rural hospitals in the Waikato. Twenty-five years ago it was clear that the model of primary care then operating in those towns was likely to be unsustainable. The practice leased premises from the Board and all the GPs moved together into a single practice. They duly offered to take on the medical cover for the hospital including the emergency department. This was a considerable commitment in that it meant that all the GPs in Te Kuiti had to be comfortable in managing acute emergencies and therefore had to commit to keeping their emergency care skills up to date. Since then the practice has been seen as the ‘go to’ rural practice for any new initiatives.

In 2005 the NZIRH, the University of Auckland and the Grassroots Club set up a Waikato weekends for 2nd year medical students interested in rural practice. After a session of skills training in
Hamilton the students were taken to Te Kuiti to see a model practice and Keith gave an inspirational talk to the students on rural general practice. Since that first weekend it has morphed into an interprofessional group of Grassroots students who spend the whole weekend in the King Country hosted by one of Keith’s partners. This Te Kuiti weekend has become a highlight of the Grassroots student program.”

Keith was a key supporter of a pilot primary health care model and instrumental in enabling Practice Nurses to trial a different way of working. His pragmatic approach and demonstrated willingness to embrace change was a key factor in enabling this project to go ahead.

He also supported a 2009 Waikato DHB Community Heart Failure project aimed at reducing admissions to hospital of primary care patients with heart failure. Te Kuiti was the ‘go to’ practice for this initiative and after a successful pilot it was then rolled out to other rural centres.”