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Health budget positive overall but little for rural NZ

PRESS RELEASE New Zealand Rural General Practice Network, May 15, for immediate use

Health budget positive overall but reveals little for rural NZ

An increase of $1.8 billion dollars to the health budget overall appears a good thing, but as always the devil is in the detail, says New Zealand Rural General Practice Network chairman Dr Jo Scott-Jones.

Finance Minister Bill English announced details of Budget 2014 on May 15. It makes available $1.8 billion for health over four years for new initiatives made up of $1.39 billion of new money and $412 million of savings. The budget also includes $90 million over three years from July 1, 2015 so primary school-aged children can go to a doctor free, any time of the day or night, and get their prescriptions free. Overall New Zealand’s public health services budget will reach a record $15.6 billion next year.

Dr Scott-Jones says the budget includes “about” $320 million available next year for extra services provided by DHBs to help meet cost pressures and population changes. However, he says the Council for Trade Unions estimated conservatively that to meet population demands DHBs would need an extra $399 million just to retain the status quo (1).

“The free care for under 6s has been provided at the expense of reduced incomes for practice owners and how the $90 million to make GP visits and prescriptions free for children aged under 13 from July 1, 2015 will be managed will be extremely interesting to watch. A free at the point of care service is very attractive and laudable, one which we would in principle support, but it has to be done in a way that is affordable.

“It costs more to provide services to a small rural community than it does to an urban community and this needs to be accounted for in any negotiations around how this money is used.”

Dr Scott-Jones says it is unclear whether the $17.8 million for post-graduate education and training of doctors announced in the Budget will be sufficient to raise the number of people training in rural practice sufficiently to meet the oncoming workforce needs.

“It certainly won’t be enough we suspect to provide the infrastructure support for additional training places in rural areas that are needed. We understand that this additional funding will see only 34 more training places created and with 140 already in place that’s 26 short of the 200 promised previously by the Government.

“It is good to see some additional funding going to the ‘up-front’ initiative for a new Healthy Families NZ campaign to encourage New Zealanders to eat healthier and exercise more and for the rheumatic fever prevention programme. We need to see more of this sort of service focussing on preventing people becoming unwell.

“We acknowledge the extra money for elective surgery, renal transplants and cochlear operations, $112.1 million for disability support services, $96 million for home-based support services, $40 million for additional support for elderly people including people with dementia, and $32.7 million for faster cancer treatment, including $8 million to increase the number of colonoscopies performed, but we want to see a particular focus on providing equity of access and outcomes for rural communities in the way these services are provided,” says Dr Scott-Jones.

(1) NZ Council of Trade Unions Working Paper on health Number 11 , May 13 2014

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