Expect GP fees to hurt, patients told

By ANGELA GREGORY

Patients will increasingly be hit in the pocket as general practitioners tire of subsidising shortfalls in Government primary care funding.

Doctors are already moving to increase consultation fees, introduce extra charges for equipment used, and bill more where consultations run over 15 minutes.

Torbay GP Dr John Pollock has asked patients to pay hundreds of dollars a year, in addition to consultation fees, to guarantee same-day appointments, home visits and cellphone access.

He said it was the only way he could offer quality care while earning a reasonable salary and getting time off for study and rest.

His move has been both applauded and condemned by some of his patients, who did not want to be named.

One 60-year-old business owner, who has now changed doctors, said he was concerned it was the thin edge of the wedge.

His medical insurance would not cover the extra charge.

"I think it's an imposition ... other patients of his have also left. They were appalled and shocked."

But another patient said he was happy to pay an extra annual $660 to ensure continuity of access.

"We have been going to Dr Pollock for many years ... we don't want to use locums and think it is an excellent service he is offering."

Doctors contacted by the Herald yesterday supported Dr Pollock in his motives, but none was thinking of following suit.

Procare, an independent practitioners association which represents nearly half Auckland's GPs, was not aware of any other doctors planning similar moves.

Chief executive Mark Wills said doctors' fees were instead starting to creep up, including charging for under 6-year-olds despite the $35 Government subsidy.

Mr Wills said fixed surgery costs had increased while subsidies had largely remained static for the past 10 years.

In some cases GPs were walking away from their surgeries, and there was low morale across the sector.

"It is pretty close to a crisis level."

An eastern suburbs GP, Dr Jonathan Fox, said doctors' incomes were falling nationwide because public funding of primary care had not kept pace with inflation.

"These are the sounds of the chickens coming home to roost from the under-investment of the health system ... practices in lower socio-economic areas are in real trouble."

Dr Fox said patients had to realise they would have to put their hands in their pockets.

"Nobody else is going to pay for it."

Doctors would be putting up their prices, there would be more charging-out for the use of medical equipment such as for smear tests, and add-ons for long consultations.

Dr Fox said the average income of an Auckland GP was probably around $70,000 and many were giving it up for more lucrative work.

Although he worked in a reasonably affluent area, he was not tempted by a scheme such as Dr Pollock's.

His biggest problem was not getting enough time off.

"It drives me to distraction ... we used to get young locum doctors from the UK, but they're now going to Australia where they are paid twice as much."

Medical Association president Dr John Adams said access to primary care was a huge issue as GP numbers were declining.

Recent surveys of medical students show that only between 13 and 16 per cent want to get into general practice.

A final-year medical student , Richard Pole, said the main disincentive was the pressure to pay off student loans, which averaged about $70,000 a graduate. Most students planned to specialise and leave the country to pay off their debts.