Patients flee clinic for cheaper care

By MARTIN JOHNSTON health reporter

A South Auckland medical practice says it is facing ruin as patients are lured by other clinics' cheaper fees, made possible by what it calls the Government's "unfair" health plans.

Drury Surgery is among four practices left on the wrong side of the financial fence in the creation of a primary health organisation that they joined.

The practices miss out on new, higher subsidies that allow the other 36 practices in the group, called Primary Health Network for Manukau, to charge patients less.

Since April 1, adults at those practices pay $10 to $20 to see a GP during normal hours, compared with $30 at Drury for those with a community services card and $45 for those without one.

"It's just so unfair for patients," said Dr Judy Goulden, who set up Drury Surgery in 1985.

But the Health Ministry says the Government's plan for universal low-cost primary healthcare involves giving it to the country's most-deprived populations first.

This is largely based on areas in which at least half the population is Maori or Pacific Islander or which are in the country's poorest fifth of neighbourhoods.

"Drury practice, with less than 10 per cent, just doesn't come close," said ministry spokesman Jim Primrose.

More than a million people are enrolled in the 34 primary health organisations set up so far. More than 700,000 of them have access to low-cost care.

Doctors' groups predict Drury is among the first of many practices that will suffer under the plan, especially in the main cities, and they claim to have already seen high-subsidy practices "poaching" patients from the others.

Dr Goulden said her 8500-patient practice, just south of Papakura, was losing clients every day to clinics in the town and within the primary health organisation's boundary, which extends to Otahuhu.

She expected Drury Surgery will to find it hard to survive more than a year.

Dr Iain Wakefield, whose clinic is also just outside the boundary, said it was possible his practice would fall victim in future.

"I've got plenty of women patients on the DPB who, when the the penny drops, I expect to lose."

Former Drury Surgery patient Sheena Cooper said her family had shifted to one of the lower-cost practices.

She has four children, one of whom has a condition requiring monthly medical appointments.

"At Drury we were paying $22 a month for an 8-year-old. Now it's free for under-18s. It's economics it comes down to all the time. It's a bit unfair."



Dr Tom Marshall, chairman of GP association ProCare, which set up the primary health organisation, said the exclusion of the four practices was unsatisfactory but unavoidable.

When the organisation was negotiating to get higher subsidies, several practices pulled out, leaving the rest below the 50 per cent threshold.

They then had to rely on a Cabinet-approved map defining where low-cost primary health organisations could be set up in South Auckland.

"I think it's wrong," Dr Marshall said of the policy.

Many GP groups pushed for the Government to spend its extra primary health millions on individuals with high health needs rather than areas of most-deprived populations, fearing that many well-off people would obtain the cheap care.

Primary health care

Thousands of New Zealanders are enrolled in primary health organisations, giving them access to low cost care.

Some existing practices say they are losing patients to nearby, heavier subsidised practices and may be forced to close.