DHBs seek to ease pain of after hours fees

Photo / Sarah Ivey

Auckland's district health boards want to reduce the high fees patients pay at accident and medical clinics after hours - but have no extra cash to offer.

Instead they hope to free up funding from public hospitals by reducing the number of people who go to their emergency departments because they can't afford private sector fees.

The DHBs are negotiating with primary healthcare leaders and A&M clinics. They hope to have a new system in place by June involving 10 after-hours clinics spread around the region.

Many patients have complained to the Herald after being charged $80, $90 and in some cases more than $100 at A&Ms during the holiday period.

James Carson wrote that he was disgusted at being charged $112 by White Cross Ascot in Auckland on Monday, a public holiday, for a 10-minute consultation.

Another correspondent said his 22-year-old son was the victim of "price gouging" by a Queenstown doctor who charged $98 for a medical certificate.

Yesterday we reported the case of Jordyn Antonio-Rooney, 18, who was charged $10 on Friday by White Cross Ponsonby for a medical consultation and change of dressing on a skin ulcer - then $66 on Monday for the same thing with the addition of a swab of the ulcer.

Her mother, Elizabeth Antonio, was incensed when told yesterday that White Cross had said the Friday fee should have been significantly higher because non-accident cases did not qualify for the lower ACC rate.

A&Ms' consultation fees vary widely, ranging from zero at some clinics for young children on weekdays during office hours, especially if they are enrolled at certain primary health organisations, to more than $100 on public holidays for non-enrolled adults without a community services card.

It's worth phoning ahead to check on fees to avoid a nasty shock. Under-6s at White Cross' West Auckland clinics cost $5 on weekdays during office hours and $36 on public holidays.

White Cross chief executive Alistair Sullivan said the chain's patient fees were so much higher after hours - unless offset by primary health organisation funding - because of the higher rates commanded at those times by health workers.

Doctors cost an effective hourly rate, including the statutory day in lieu, of up to $285 for working on a public holiday.

Dr Sullivan said the after-hours fees had led to fewer patients for many clinics. "Of the 22 A&Ms in greater Auckland, only seven are now open until 10pm or later. A year ago they virtually all were."

COST TO PATIENTS

A sample of fees at White Cross Ascot for a first medical consultation

ADULT

Weekday office hours: no community services card, $72; enrolled in Tamaki Healthcare primary health organisation, $35.
Weekday evenings and weekends to 10pm: No CS card, $97; enrolled, $35.
Overnight: no CSC, after hours, $87; enrolled, $35.
Public holidays: no CSC, $112; enrolled, $35.

CHILD UNDER 6

Weekday office hours: $10; or if enrolled in Tamaki Healthcare, free.
Weekday evenings and weekends to 10pm: $31; enrolled, $5.
Overnight: $20; enrolled, $5.
Public holidays: $36; enrolled, $5.