Bryan Betty, medical director at the Royal New Zealand College of General Practitioners (RNZCGP), says our current funding model is absolutely flawed. Photo / Supplied
Bryan Betty, medical director at the Royal New Zealand College of General Practitioners (RNZCGP), says our current funding model is absolutely flawed. Photo / Supplied
Should New Zealanders pay to see a doctor - particularly those who can't afford it?
That's the thorny question health experts are considering amid the country's biggest-ever health shakeup.
It comes after Health Minister Andrew Little last week announced all District Health Boards would be replaced with one national bodydesigned to end "postcode lottery" - which means the quality of treatment depends on where you live.
In Auckland, enrolled adult patients can pay between $10 and $70 for a doctor's appointment depending on which general practice they visit.
A Herald analysis of GP fees across Auckland also revealed that despite having a Community Services Card - which is given to those with a low income - patients could still be paying up to $90 if they weren't enrolled.
One union leader says there are still big questions hanging over GPs.
"I don't think we've fully comprehended how much change is coming," Sarah Dalton, executive director of senior doctors union Association of Salaried Medical Specialists (ASMS), told the Herald.
"Will patients still pay to see a GP? Will all the general practices become directly employed by Health New Zealand? These are massive questions and I'm not sure there has been an answer yet," she said.
Sarah Dalton, executive director of senior doctors union Association of Salaried Medical Specialists (ASMS). Photo / Supplied
Bryan Betty, medical director at the Royal New Zealand College of General Practitioners (RNZCGP), said there had been no indication from the Government of abolishing GP fees but timely access for those who couldn't afford to see a doctor was a crucial problem across the country.
Betty - who is also a GP in Porirua - was critical of the current GP funding model saying it was outdated and "absolutely flawed".
If more than 50 per cent of its enrolled patients are on low incomes, the clinic can apply for extra funding from the Government to reduce its fees.
The problem is if you have 30 or 40 per cent of patients who can't afford to pay they miss out, Betty said.
"Frankly every GP in the country now has 'high-need patients' ... this model is absolutely flawed."
The Porirua doctor said failures in information sharing between health agencies had also been an "ongoing problem" for the last 20 years and had not been resolved.
"We need to bring things together so we can have clear communication ... in New Zealand essentially you have 20 different data systems that don't communicate with each other and it puts us in this very difficult situation of transmitting data.
"It will certainly take a lot of investment to achieve," Betty said.
Little told the Herald no decisions had been made on co-payment arrangements, affecting GP fees, but he was expecting "policy advice" to improve access to those services.
The Herald also asked Little if he wanted to move away from privatisation of primary care (including general practices and community health providers). He said: "No decisions have been made on future models for individual services."
"The advice and decisions to date has focused on the foundations of the future system operating model. Further work will occur over the coming months to provide more detailed design of the operating model," Little said.
A single database for all health services, including GPs and other community health services, is the goal, Little said.
"Officials will provide advice in the coming months on enablers like data and digital, roles and accountabilities relating to these functions and priorities," he said.
Minister for Health Andrew Little. Photo / Bevan Conley
The new national body, dubbed Health New Zealand, was set to come into effect from July next year.
A commissioner will be appointed for each region to keep regional priorities in focus.
A new Māori health authority will also be established, with the power to commission health services and monitor Māori health, as well as developing policy.
The major announcements are:
• All DHBs will be replaced by one national health body, Health New Zealand, to fund and run the health system.
• A new Māori health authority will be created, with power to commission health services.
• The Ministry of Health will become an advisory and policy agency only.
• A new public health agency will be created within the Ministry of Health.
