The Tōtara Health clinics will continue to supply free healthcare to children aged 14 to 17 after the Hawke's Bay District Health Board pulled its district-wide funding.
In October last year, general practitioners across the region were told subsidised free GP services to 14–17-year-olds would finish on March 31 this year.
Tōtara Health general manager Shane Gorst said there is no free service for rangatahi except that funded by individual practices like Totara between April 1 and July 1.
The Hastings and Flaxmere GP service has been self-funding free service for this demographic since 2015.
"Well before the DHB decided to introduce this funding across the region," said Gorst.
Tōtara Health provides free access to these services because it believes its patients need support. "Removing the cost barrier is one crucial and simple way that they can support our community by improving access to care," Gorst said.
"We sustained these services before their support, and we will continue to sustain them regardless of whether the DHB reviews its decision, because our community need us to provide this support for them," he said.
"The need hasn't changed, nor have the reasons that the GP started funding this in the first place."
Not all Hawke's Bay GP services have the ability to self-fund care for their young teens.
Gorst said general practices are left to decide, based on their individual circumstances, whether they can afford to self-fund the service and carry the consequences of the DHB's actions.
Hawke's Bay DHB revealed it plans to replace the old service with a new service, with a collective of Māori providers, and that the new service would be for all rangatahi.
Many are worried that even with a new service in place, the more than 22,000 rangatahi aged 10 – 24 living in Hawke's Bay will not be able to receive help.
The new service to be delivered by the collective - for all 10- to 24-year-olds in Hawke's Bay - was based on a model of care outlined in a document named "Hauora Rangatahi", released in December 2019.
The Hauora Rangatahi document calls specifically for a kaupapa Maori service to be developed.
Gorst said that of the five providers making up the new collective "Kahui Waiora", the only one employing general practitioners is Hauora Heretaunga.
Hauora Heretaunga is based out of Te Taiwhenua o Heretaunga and is advertising that "high demand means that enrolments at Hauora Heretaunga are subject to availability".
Gorst asked how the collective will be able to provide what the DHB has publically stated they are going to provide, from July 1, for more than 22,000 young people.
The Hawke's Bay DHB executive director planning funding and performance, Emma Foster, said the HBDHB acknowledges some confusion surrounding the new rangatahi service.
She also said there had been "insufficient" communication to some stakeholders around the replacement service.
As a part of the DHB's new service, Foster said the intent is that the rangatahi service will also offer a standard co-payment to reduce and, in some cases, eliminate the barrier of cost to access general practice services.
More information on how general practice can access the rangatahi service will follow in the next few weeks.
Tōtara Health GM said, "Our whānau are under more pressure than ever before, so introducing a cost barrier now goes against what we are trying to achieve.
"Everyone is struggling with the stress and uncertainty of the pandemic, the cost of living and other challenges. The impact on the community will be that many young people who could previously access free care through their GP will no longer be able to do so.
"In many cases, this will mean they receive no care at all or that the care they do receive will be disconnected from the clinicians they have come to know and trust over years of relationship building," Gorst said.
"Decisions such as this one by the Hawke's Bay DHB have a significant impact on general practice and inevitably on some of the services we can provide to your family."