2nd Ave Accident and Healthcare manager Dave Gilbert says it is increasing its charges to patients due to a lack of funding from Te Whatu Ora. Photo / Alex Cairns
2nd Ave Accident and Healthcare manager Dave Gilbert says it is increasing its charges to patients due to a lack of funding from Te Whatu Ora. Photo / Alex Cairns
A cash-strapped urgent care clinic in Tauranga is increasing children’s fees by up to $70 a visit to try and keep its doors open, saying the “awful situation” will hurt “a lot of families”.
The local primary health organisation (PHO) says this is because of “insufficient” funding and it wouldbe “extremely serious” if the clinic, which serves 60,000 people a year, closes.
Te Whatu Ora - Health NZ says it wants the clinic and PHO to strike an agreement to keep GP care free for under-14s while a longer-term plan is worked out.
It is initiating a nationwide review as other urgent care services around New Zealand face similar pressures, with some closing or reducing hours.
2nd Ave Accident and Healthcare medical clinic offers acute walk-in, accident and medical care in the Western Bay of Plenty, including after-hours.
It increased its charges for children on October 12, with some medical consultations now $135.
Clinic manager Dave Gilbert said the business was not “financially sustainable” without an increase in fees or government funding.
2nd Ave Accident and Healthcare manager Dave Gilbert says it is increasing its charges to patients due to a lack of funding from Te Whatu Ora. Photo / Alex Cairns
Gilbert told the Bay of Plenty Times Weekend it had to increase charges for children due to a lack of funding from Te Whatu Ora - Health NZ “some of which has not changed in the 30 years we have been in operation”.
The price for a daytime medical consultation for children under 6 years old had risen to $50 at all hours.
For children aged 6–13, the day price doubled to $50, and would cost $70 after-hours instead of $0.
Children aged 14–17 would pay $115 during the day instead of $65, and $135 after-hours instead of $85.
“A lot of families are going to get hurt by this but we don’t have a choice. We are really squeezed. It’s an awful situation,” Gilbert said.
“The reality is our staffing costs in addition to all overheads have continued to increase dramatically and without any increase in fees or funding our business is not financially sustainable.
“We have requested a review of our subsidies for children from Te Whatu Ora on a number of occasions with no result.”
Gilbert said the team was concerned about the impact of the fee increases on families and Tauranga Hospital’s Emergency Department, and has expressed this to Te Whatu Ora.
“They have acknowledged our concerns but are not prepared to increase our subsidies to assist in any way,” he said.
“This, unfortunately, has left us with no other choice than to recoup the costs from patients.”
The emergency department was already “bursting at the seams”, Gilbert said.
“Sadly, some patients who need to see a doctor may otherwise stay at home. This is particularly concerning with children under 6 months who can deteriorate very rapidly.
“It’s not a great prognosis for our community.”
Gilbert said the move pained him and his team, who struggled to understand how they were not able to receive more support for the service they provided.
“Our staff, and I imagine most of [the] urgent care staff around the country, feel incredibly let down and frustrated by Te Whatu Ora
In his view, it seemed Te Whatu Ora had “little or no idea of the costs of running an urgent care clinic”.
“We are in the business of helping people in their time of need, and what we are being forced to do is completely contrary to this.”
Western Bay of Plenty Primary Health Organisation (PHO) board co-chair Dr Daniel McIntosh said it was informed last week the clinic was “at-risk of closure” due to “insufficient” funding, and was increasing fees was an attempt to maintain operations “in the short-term”.
He said the clinic treated about 60,000 people a year, alleviating pressure on the Tauranga Hospital ED and general practices.
“An increase in fees will impact the most vulnerable, who simply will not be able to afford this vital service.”
McIntosh said it would be a “huge setback” in promoting health equity and the consequences of closure would be “extremely serious” due to the reduced availability of acute care.
“We are at risk of losing the only after-hours provider offering 365-day acute walk-in, accident and medical care in the Western Bay of Plenty.”
Western Bay of Plenty Providers Inc chairman Dr Luke Bradford pictured in 2022. Photo / Mead Norton
Dr Luke Bradford said the fee increase could result in children not seeking treatment or “flooding the emergency department which will further strain the hospital”.
He is the chairman of Western Bay of Plenty Providers Inc, an umbrella organisation for general practices and organisations involved with podiatry, asthma/respiration, hauora, and mental health.
Bradford said he understood the clinic’s decision “because their funding model is not sustainable”.
Bradford said it was part of a national problem of “underinvestment” in primary care and he was anecdotally hearing of other urgent care centres with the same issues.
He encouraged people to contact their GP during business hours for healthcare, as general practices were available for their enrolled populations and free for children under the age of 14.
Te Whatu Ora’s Mike Agnew said it had “recently become aware” of the concerns raised by the clinic.
He said Te Whatu Ora and PHOs worked with general practice teams to secure after-hours urgent medical care services.
Te Whatu Ora had a contract with the Western Bay PHO to deliver primary care services for the region, and the PHO subcontracted 2nd Avenue Health Centre for urgent after-hours care.
As the contract holder, the PHO was responsible for managing negotiations with the clinic, he said.
“We’ve asked them to come to an agreement … that ensures free GP visits for children under 14 continue to be provided, while the parties explore longer-term options.”
He said patient could call Healthline, a local pharmacy or general practice for advice on non-urgent issues.
“We encourage people to call 111 or go to an emergency department if they are experiencing a medical emergency.”
Agnew said a national review of “the provision of unscheduled/unplanned, urgent care and after-hours services” was being initiated. It would look at how the service networks involved were working and what needed to be done to strengthen them, “including looking at key areas of service vulnerability and cost pressures”.
He said cost and staffing pressures had led to short-term closures or reduced opening hours at some urgent care facilities around New Zealand.
There were more than 100 after-hours providers and he said additional funding was one of the actions being taken to support those who needed it.
Kiri Gillespie is an assistant news director and a senior journalist for the Bay of Plenty Times and Rotorua Daily Post, specialising in local politics and city issues. She was a finalist for the Voyager Media Awards Regional Journalist of the Year in 2021.
Megan Wilson is a health and general news reporter for the Bay of Plenty Times and Rotorua Daily Post. She has been a journalist since 2021.
