Doctor fee hikes to end as funding wrangle finishes? GP rep says outcome ‘promising’

GenPro chairman Dr Angus Chambers said pressure on GP fees may be less this year because of funding increases. Photo / George Heard

GPs are quietly confident they will get a funding increase to at least cover their costs as weeks of tense negotiations with Health New Zealand Te Whatu Ora come to a close.

That could be good news for patients, because practices would be under less pressure to raise their consultation fees this year.

However, some say years of underfunding still leaves primary care in a difficult position.

General practice representatives are in the final stages of negotiations with Health NZ on their funding increase for the next year.

GenPro chairman Dr Angus Chambers, whose organisation represents practice owners, said he could not disclose how the talks were progressing but that the outcome was looking “promising”.

That could mean that Health NZ will agree to lift funding by up to 6.4%, which is the estimate of how much general practice costs rose by in the last year.

GPs are funded according to how many enrolled patients they have – known as capitation – and negotiate an increase to the overall amount each year. Health NZ also sets a limit on how much they can increase their fees by.

The Government earlier this year announced an additional funding increase of $285 million over three years for GP clinics that fulfil certain criteria.

“I think it’s reasonable to say with the announcements that have been made – notwithstanding some people won’t get the extra money that’s been announced – the pressure on increased fees this year is less than it has been in previous years,” Chambers said. “So that’s promising from a patient point of view as well at this point in time.”

The details of how GPs will be able to access the additional $95m in payments are not yet known and are part of the negotiations.

Health Minister Simeon Brown has previously said the “performance-based” funding will be available to GPs who keep their books open to new patients or increase immunisation rates.

Some GPs said a 6.4% increase would be the bare minimum.

“We’ve been underfunded for 20 successive years so if we genuinely are going to catch up then we need a hell of a lot more than 6%,” said Dr Buzz Burrell, the chairman of General Practice Aotearoa, which represents primary care doctors.

The 6.4% figure is the estimated increase required for general practice to “stand still” and does not take into account unmet need or the higher costs of an ageing population.

Health Minister Simeon Brown said the Government wanted to keep GP fees down. Photo / RNZ

Labour Party health spokeswoman Ayesha Verrall said those extra costs were previously estimated to be another $200m a year.

“That means general practices will continue to close and people won’t be able to access care when they need it,” Verrall said.

Last year, cost pressures rose by 5.8% but funding was lifted by just 4%. Clinics were permitted to lift their fees to a maximum of 7.7%. A GenPro survey of nearly 250 practices at the time found that 90% planned to increase their fees to make up the funding shortfall.

The latest New Zealand Health Survey found one in six adults reported not visiting a GP due to cost over the previous 12 months.

Brown said yesterday that the primary care funding negotiations were ongoing but that the Government wanted to “keep fees down”.

He also noted several other primary care initiatives in this year’s Budget, including more funding for urgent care, a 24/7 telehealth service, which is being launched next month, and funding for more doctors, nurse practitioners and nurse prescribers.

The primary care funding model is currently being reviewed because of concerns it is based too narrowly on age and gender and does not take into account other factors such as deprivation or comorbidities.

The level of funding is generally the same for a 65-year-old and an 85-year-old, yet the older age group is likely to require far more GP visits and healthcare. And in the 20 years since the funding model was introduced, the rate of older patients with more complicated illnesses has increased.

Isaac Davison is a senior reporter who covers Auckland issues. He joined the Herald in 2008 and has previously covered the environment, politics, social issues, and healthcare.

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