Cheap GP visits to be rewarded

The extra money will benefit families like this one, pictured at the Otara Union Health Centre. Picture / Dean Purcell

Medical clinics that keep patients' fees low will be rewarded with an extra $43 million from the Government over four years.

The new money - aimed mainly at communities with high needs - is to offset pressure to increase fees, such as from higher GP salaries.

To qualify for the top-up - effectively $4.15 for each visit by a school-aged child or adult and $5.80 for under-6s - clinics must charge no more than $15 for adults, $10 for children 6 to 17 and nothing for younger children.

Primary Health Organisations (PHOs) will be given extra money if all their practices qualify for the low-fees top-up.

Clinics covering some 615,000 people are expected to qualify.

Health Minister Pete Hodgson said the $43 million was to recognise the extra effort in providing services to concentrated high-need populations.

"The Labour-led Government believes that no family should have to choose between putting food on the table and paying for the cost of a doctor's visit."

The new policy was welcomed by a PHO whose clinics have low fees, but treated cautiously by the Medical Association's General Practice Council.

It marks a reversal. The Government was progressively bringing primary health care subsidies for everyone up to the level paid in areas of highest deprivation and Maori or Pacific Island population, so-called "access funding". Those aged 25-44 will be the last group given universal subsidies, in July.

Mr Hodgson's office said last month the remaining differentials would disappear next July.

Yesterday, his spokesman acknowledged that subsidy differences would now be retained, but said they were much smaller than those between the access and other funding levels.

GP Council chairman Dr Peter Foley said the Government was retaining a "crude" method of targeting funding based on where people lived, rather than on individuals' health needs. In the past this had created border problems between higher and lower subsidy areas and risked undermining clinics by patients being lured over the border.

He was also concerned about clinics agreeing to a fees cap.

National's health spokesman Tony Ryall restated his party's opposition to geographical subsidy differences - what he called "healthcare by postcode."

"Under Labour, your address counts for more than how sick you are. Beneficiaries or low-income workers in one part of a city will get more Government help than even more needy people in another part of the same city. That's totally unfair."

Brent Morissey, manager of the Otara Union Health Centre - which charges nothing for children of school age or younger and $10 for adults - said the new money would enable it to hold its fees at current levels despite rising costs.

Petra van den Munckhof, national co-ordinator of Health Care Aotearoa - the PHO for 200,000 Maori, Pacific and low-income people, including those with the Otara centre - said the services that would benefit from the new money were struggling to survive.


GP fees

* Average around $17 for adults at "access" practices (serving areas of highest deprivation and Maori or Pacific population).
* Maximum of $50 at access practices.
* Elsewhere the average is around $27 and the maximum up to $63.
Source: Minister of Health