Low-cost GP appointments going to those ‘who don’t deserve it’

Some doctors say the Government funding system that supports cheaper visits is “inequitable”. Photo / Getty Images

The Government funding system that supports cheaper visits to the doctor is being challenged by medical professionals who say it’s “inequitable”.

The Very Low-Cost Access Scheme (VLCA) means clinical practices with an enrolled patient population of 50 per cent or more high-needs patients are given additional funding from the Government.

Patients who enrol at VLCA clinics will be charged lower fees for appointments, and the cost for adults over the age of 18 is $19.50.

Jabulani Medical Centre director and practice manager Tanya Brown said the VLCA practice system was very unfair and should be restructured.

“Millions of dollars are being spent on patients in those practices, who don’t deserve that funding because they are not high-needs low-income patients, and they don’t have Community Service Cards.”

Brown said about 38 per cent of patients at her practice were high-needs low-income patients, but this was not enough to meet the threshold.

“People will not come to appointments because they can’t afford to pay and they’ll end up more sick.

“The funding affects what the patient pays at the end of the day, but most people don’t realise that.

“Unless you were historically a VLCA practice, it’s difficult to become one. It all depends on your patient population.”

A Te Whatu Ora - Health New Zealand spokesperson said Gonville Health, Ruapehu Health, Stewart Street Surgery, Taihape Health, Te Oranganui – Te Waipuna and Living Waters were part of the VLCA scheme.

“This is a voluntary scheme that general practices can opt out of at any time, should they find it is no longer appropriate.”

Gonville Health clinical director Dr John McMenamin said the focus for VLCA practices was on the health of populations from areas of deprivation.

“The concept of funding a lower-cost service needs to remain. It helps ensure access to healthcare, as we know cost is a major barrier for many people.

“Inevitably, some patients will not personally be as impacted by deprivation as others, but to be a VLCA practice, the practice population profile needs to meet the criteria.”

McMenamin said one of the main outcomes of the cost barrier to healthcare was overloaded initial consultations, instead of patients seeking follow-up appointments.

“Ideally, access to healthcare would be as free for primary care as it is for secondary care.”

GenPro chief executive Mark Liddell said under the current system, affluent populations could be served by VLCA practices.

“It’s accessed by people who can easily afford to pay for their own care because if you’re enrolled with a VLCA practice, but you’re not high-needs or a priority population, you still get the same cost.

“It should be a better form of targeted funding.”

Liddell said the investment in VLCA practices should be going towards creating better health outcomes.

“We are pushing for a change in funding, but the health reforms will hopefully provide the opportunity for a review of the system so the Government can understand what’s needed at the coalface.”

Eva de Jong is a reporter for the Whanganui Chronicle covering health stories and general news. She began as a reporter in 2023.