National to scrap cap on GPs' fees

By Sue Eden

The National Party plans to scrap the Government's controls on doctors' fees meaning patients could pay more to see their doctor.

National leader John Key said the competitive market would ensure doctors' fees did not go through the roof.

While no guarantees could be given over fee rises, Mr Key said doctors were not solely concerned about money.

This aspect of National Party policy came out during a press conference to release National's discussion document on health which it said was about "putting patients first".

The government subsidises patient visits to keep doctors' fees down so that people will see their GP before their health problems escalate to the point they have to go to hospital.

Doctors charge part-fees on top of the government subsidy they receive.

The Government reviews GPs' fees that seem unreasonably high.

National's health spokesman Tony Ryall told reporters today that GPs felt the Government's was fixated with controlling their fees.

"We don't support Labour's fees control system. We'll be knocking it on the head," Mr Ryall said.

"We don't think that this control system that the Government's got is working, it's quite unnecessary, and competitive pressures make sure that the charges of doctors are reasonable," he said.

He said the relationship National would have with doctors would be a much more "trusting relationship and a relationship of mutual respect".

Mr Ryall said no one could guarantee GP charges would not go up but he did not believe New Zealanders would pay more.

Mr Key said it would be up to "the market" and if doctors charged too much "then probably someone will go down the road".

Asked what would stop small town doctors hiking their fees given they faced little competition, Mr Key said "country GPs aren't exactly know for being rip-off merchants".

Mr Ryall said he had previously "announced" in speeches to the health sector that National would scrap the fee review system, but this has not been widely reported.

Prime Minister Helen Clark told reporters National's "secret agenda" had been flushed out given that there was nothing in National's discussion document about this policy.

"There's a very good reason for the subsidies having a capped co-payment and that is to ensure primary health care is kept affordable for people," Miss Clark said.

"Experience in the past has been that where you do not apply a cap the fees creep and creep and creep away from the subsidy level and you end up with very unaffordable care as a result."

Miss Clark also said there was a shortage of GPs in many areas and it was not easy for patients to simply swap to avoid higher fees under the market approach National was advocating.

Health Minister Pete Hodgson said doctors were allowed to put their fees up each year, generally at about the level of inflation.

If they put their fees up more than that they had to justify it through a fee services review process.

National's 50-page discussion document goes out for consultation before it will formulate its final policy.

The National Party is not proposing any major changes to the current structure of 21 district health boards.

Among its proposals are:

* GP services in hospital emergency departments to reduce the delays patients were facing in being seen;

* Freeing up capacity in private hospitals for publicly-funded elective surgery;

* Clinical networks across regions to assist in planning, delivery and evaluating services. These networks would involve clinicians, non-government organisation and patients;

* Re-locating some hospital services to Integrated Family Health Centres which would provide a full range of services including specialist assessments by GPs and minor surgery.

Mr Key did not give any costings today, saying these would be released by Finance Minister Bill English next year.

He could not say whether National would keep to the same funding track Labour has which had been running at about "8 per cent plus" a year.

He said health funding would increase but National hoped to make savings by cutting bureaucracy, including by taking a look at staffing at the Ministry of Health, while delivering greater productivity.


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