Budget 2023: Primary care eyed as solution to hospital pressure as winter approaches

The key highlights:

• Extension of 20 hours Early Childhood Education to include 2-year-olds - $1.2b
• Abolition of $5 prescription co-payment - $619m
• Cheaper public transport for children - $327m
• $71b in infrastructure spending
• Inflation forecast to stay higher, for longer
• Net core Crown debt hits $181b

The Government is attempting to tackle dire waiting times in hospital emergency departments, as well as lengthy waitlists for planned care, through hundreds of millions spent this year with a focus on preparing for winter.

It has also made prescription medicines free by removing the $5 co-payment.

Budget 2023 supplied more than $200 million in the coming year would be devoted to providing primary and community care closer to people’s homes, reducing pressure on hospitals and speeding up discharge from hospitals through community-based care for older people.

It would also help to reduce waiting lists for planned surgeries by improving patient flow, enabling planned care to be provided in primary settings and freeing up inpatient hospital beds to allow more surgeries to go ahead.

Almost $100m would have a focus on the upcoming winter season while $118m would be directed toward easing planned care pressures.

Reports of the maximum six-hour wait-time target in hospitals being exceeded were widespread, with admissions from top health officials that hospitals struggled to meet the target.

Verrall recently outlined the Te Whatu Ora-led 2023 Winter Plan, which included 24 initiatives to help support community care and reduce hospital demand.

Measures ranged from supporting pharmacies to treat minor ailments, hospital-in-the-home services, increased access to radiology service in the community and community rapid response tools to lessen hospital admissions for the most vulnerable people.

“Primary and community care are key to reducing pressure on hospital services and providing people the care they need when and where they need it,” Health Minister Dr Ayesha Verrall said.

“In 2023/24, we are putting an extra half a billion dollars into primary and community care sector, to support sector stability and to reduce pay disparities overtime between hospital and community health sector staff.”

In April, Verrall and Associate Health Minister Peeni Henare announced a $44m funding boost for primary care providers to deliver high-quality services focused on benefitting Māori and Pacific populations.

The funding, which would roll out over two years, would directly impact those with the highest needs in New Zealand.

“This funding will support the establishment of comprehensive primary care teams, build capacity in the workforce, and address the burden of under-funding for Māori and Pacific providers,” Verrall said.

“We will also allocate $4.9m for the training and development of the new kaiāwhina workforce to support these teams.”

A targeted investment of $37m over the next two years was intended to more equitably allocate primary care funding to general practices based on their enrolled high-needs populations, and those providers with the highest Māori and Pacific populations.

Almost 200 additional frontline clinical team members across the country would be resourced across primary, community and rural care to focus on “early intervention, faster treatment and better support for whānau”, Verrall said.

Also referenced in Budget 2023 was the extraordinary cost to correct payments made under the Holidays Act 2003.

It was projected that about $1.6b would be required from Budget 2023 and a further $600m from Budget 2024 would be required for the “remediation and resolution” of historical claims for pay under the Holidays Act.