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Funding welcome, but concern remains

Sunday, 27 August 2006

Funding welcome, but concern at how it will be implemented

The New Zealand Medical Association is concerned about the way new funding for improving access to primary care is being introduced.

Health Minister Pete Hodgson announced today that general practices that charge very low fees will receive extra government funding of $43 million over four years.

"Additional funding, to make it easier for those who struggle to get primary health care, is always welcome," said Dr Peter Foley, who chairs the NZMA's GP Council. "We applaud the Government providing additional support to improve access to primary health care from our general practice teams. However, the NZMA has significant concerns about how the Government is planning to implement this.

"The latest increase is not targeted directly at those people most in need. While it will generally go to the most needy areas, people on a good income in those areas will get fee reductions while poorer people in other areas will not qualify."

Dr Foley said the amount people pay in fees should not just depend on where they live. Funding should instead be targeted at those most in need.

"The NZMA is also greatly concerned that the extra funding is being offered in exchange for the capping of fees. Most general practices operate as a business and need to be free to set their fees at a level where they can ensure their viability."

The NZMA has always opposed fee capping and earlier this year worked long and hard with other general practice organisations to ensure this was avoided when funding was rolled out for 45-64 year olds. In that case commonsense prevailed. Patients benefited by receiving the subsidy, and general practices could ensure their viability by being able to set their own fees. General practice has a long history of passing on government subsidies to patients.

"Surely the Government has learnt from that process that GPs are to be trusted to set fees at appropriate levels."

"General practice realizes its central importance to the New Zealand health system, and wishes there were not financial barriers preventing some patients from accessing needed care. However, the reality is that the increasing demands of the primary care strategy induce more work and increased costs to the sector. This new announcement may help some patients, but also has the potential to further destabilize the New Zealand general practice workforce," Dr Foley said.

The new funding regime has been developed in isolation from general practice, with no consultation with the major sector groups. The NZMA will be looking closely at both the policy and operational implications, and will provide advice to its general practitioner members accordingly.


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