Brash does u-turn on GP subsidy

Don Brash

Up to several hundred thousand people would lose subsidies for GP visits and prescriptions under National - a week after leader Don Brash gave assurances they wouldn't.

Announcing the details of National's health policy yesterday, Dr Brash admitted that when he told the Herald his party would retain universal health subsidies in regions where they were already in place "that was a mistake".

On Monday, Dr Brash told TVNZ he did not know if National would reintroduce market rents for state housing tenants, despite it being confirmed in a housing policy released that day.

Health Minister Annette King yesterday described the situation as a "tragedy of errors" and said costings in National's health policy were wrong.

The Herald questioned Dr Brash on the subsidy issue after he assured a public meeting in Kerikeri last week that people in the town would retain their cheap doctors visits under National.

The entire Northland region is covered by an Access Primary Health Organisation, which means the whole population receives $26 subsidies for doctors visits and pays $3 - rather than $15 - per prescription.

Weeks before he spoke at Kerikeri, Dr Brash had said National did not support universal subsidies.

But he had not clarified if it would just halt them being introduced for everyone (as Labour plans by 2007) or take a step further and unwind back those already in place.

He has now confirmed that National will take the latter approach over time in negotiation with district health boards, which will eventually strip the subsidies from all people aged 25-64 living in Access PHO regions who are not on low incomes.

Just over one million people are enrolled in Access PHOs - poorer regions where funding was targeted first - and a further 2.7 million are enrolled in Interim PHOs.

The latter receive the subsidies if they are under 25 or over 64 - subsidies which National will retain.

People outside those age groups and enrolled at Interim PHOs can also get subsidies through the community services card if they are on low incomes.

National will keep the card, but rename it the health card.

Health spokesman Paul Hutchison said the income eligibility threshold for the cards would be "substantially" increased - but he could not say by how much.

A single person is now entitled to a discount if he earns less than $20,275. A four-person family's eligibility cuts off at $45,498.

National will increase the health card subsidy from $15 a visit to $30.

It said it would save $180 million annually by halting the universal expansion of the subsidy but could not say how much it would save from ending existing subsidies.

Dr Hutchison could not say how many people in Access PHOs would lose subsidies.

But he said there were many wealthy people accessing them in South Auckland alone and he believed the total number would run into the "low hundreds of thousands".

The Ministry of Health said 70 per cent of those between 25 and 64 in Access PHOs were not getting community services cards - but could not say what proportion of the 1 million patients that group made up.

National will reinvest the $180 million, putting about $70 million into the health card and an extra $53 million over three years into pharmaceuticals.

National v Labour

* National finance spokesman John Key calculates National will spend about $300 million less a year than Labour on health.
* Labour is now spending $9.6 billion a year and has pledged to spend another $1 billion a year over the next four years and a further $489 million in 2006-07.
* Mr Key says National will match that. But the tax cuts will mean it will have less surplus cash than Labour to top up health spending.

- additional reporting: Ainsley Thomson