A proposal for free GP visits for 13- to 17-year-olds will be decided by the Hawke's Bay District Health Board (HBDHB) on Wednesday.
Unique to Hawke's Bay and due to go live from January, it first needs board approval to subsidise all under-18s in 14 practices with high numbers of Maori and Pacific patients, if the practices choose to join the scheme. Under-13s are already free, due to government funding.
It is estimated the proposal, two years in the planning, will reach 53 per cent of the age group, targeting Maori and Pacific populations.
"The New Zealand Health Survey 2013-2014 found that cost is the most significant barrier to accessing primary-care service in New Zealand," a report on the proposal said.
"In Hawke's Bay the survey found that youth [15-24 years] have higher rates of unmet need for primary care than NZ national average [34 per cent compared to 23 per cent]."
HBDHB general manager performance, informatics and finance Tim Evans said whole practices were targeted, as opposed to Maori and Pacific teens, because practices needed to make significant changes to be eligible for the zero-fees scheme.
He said health inequities were due to cultural (on average Maori live eight years less than Pakeha) and deprivation issues.
"It is slightly more subtle than Maori versus Pakeha," he said.
"We need to pick up whole practices. This isn't about the relationship between the HBDHB and the individual, it is about the relationship between the practice and the enrolled population."
He said families may choose switch to different health practices in order to take advantage of the free health care.
It was a "pretty big" pilot programme and if successful would be rolled out to the whole region for the age group.
"It is about early intervention, building a relationship with a general practice and seeing it as the first place you expect to have a relationship with about your health [rather than] waiting until you are desperately ill and turning up at ED because it is free."
The downstream benefit would be both better health and cost savings.
Labour's Tukituki candidate Anna Lorck applauded the proposal.
"Cost and access to a doctor are once again showing the widening inequality gap that is becoming a huge social, health and economic challenge for our youth in our region," she said.
"This $500,000 investment to provide zero fees for 13- to 17-year-olds living in our most impoverished areas across Hawke's Bay, based on an average two visits a year, could well break down a real barrier to encouraging younger people to take better care of their health.
Mr Evans said he knew of no other DHB that had "pushed along this path".
"What's important to me is what is good for Hawke's Bay."
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