Free clinic extended to poor Pakeha

A doctors' group has extended access to a free diabetes clinic to low-income Pakeha who were briefly excluded because they did not live in the poorest neighbourhoods.

The Napier-Hastings group, called The Doctors, blames a too-strict reading of Health Ministry funding rules, but the National Party says the rules are "racist".

The Government has been under pressure this year over policies that favour Maori and in response is reviewing 23 policies and programmes, including the New Zealand Health Strategy.

The ministry provides Services-to-Improve-Access (SIA) funding to health clinics to deliver more health care to "high-needs groups, in particular Maori, Pacific Islanders and those on low incomes".

Under a contract that started with a Hawkes Bay primary health funder in September, The Doctors offered free clinics including diabetes, asthma, smoking cessation, heart disease, healthy eating, cervical screening and mental wellbeing. They were for Maori, Pacific Islanders and anyone who lived in their catchment's areas of greatest poverty. This excluded Pakeha who lived in other areas even if they were poor.

But The Doctors marketing manager Susan Jenkins said yesterday that the funder, the Hawkes Bay Primary Health Organisation (PHO), had relaxed its interpretation.

This allowed the nurse-led clinics to be extended to all low income or high health needs people - those who had a community services card or high-user health card - regardless of where they lived.

"The PHO applied the rules according to the letter ... But then they looked again and said we can include community services and high-user card people. Previously we have run these clinics at low cost. SIA funding makes us able to offer them for free for people who qualify under the rules."

National's health spokeswoman Judith Collins welcomed the "climb down" but said the Services-to-Improve-Access funding regime was "racist".

Treatment should be based only on need, not race and to deny someone because they had the wrong colour skin or lived at the wrong address was "political correctness".

But the PHO chairman, Hamish Kynoch, said: "The policy is quite clear. It's targeted at populations with the highest health needs. There's ample evidence health needs of Maori are high, irrespective of socio-economic status."

The ministry's deputy director-general for clinical services, Colin Feek, said the initial targeting of PHO funding at Maori, Pacific Islanders and poor people was justified because on average their health was worse than other groups and they died younger.

PHOs and practices with high concentrations of Maori, Pacific, and poor people of other ethnic groups attract higher funding than others, allowing a reduction in co-payments for their enrolled patients. The Government is progressively increasing money given to other PHOs, allowing reduced co-payments for the elderly and school-aged children.

Dr Feek said that by July 2007 the Government intended to have in place a health benefits scheme allowing low-cost care for everybody.