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Christchurch GPs prescribe affordable health

Hon Lianne Dalziel

Minister of Commerce, Minister for Small Business,

Minister of Women’s Affairs, MP for Christchurch East

13 October 2006 Media Statement

Christchurch GPs prescribe affordable health

Christchurch East MP Lianne Dalziel has welcomed extra government funding for eight Christchurch general practices that charge very low fees for patients.

"It's great to see that these general practitioners are charging less than $15 for adults and nothing for children under six years of age. This obviously makes their services a lot more accessible and affordable for their patients. They're to be commended for their dedication to the health of the community," said Lianne Dalziel.

The additional help for local doctors is coming from money announced in August by Health Minister Pete Hodgson, as part of the Labour-led government's latest investment in primary health care. The government is investing $43 million in practices charging very low fees, to ensure their long-term financial stability.

"This government is committed to the health of Kiwi families. We're dramatically reducing the cost of seeing the family doctor. But it's a worry that some practices providing very low cost access – the same ones who often serve high need communities – have been facing difficulties retaining staff and maintaining facilities. Any GP who chooses to charge very low fees to ensure community health deserves to have this additional backing." Lianne Dalziel said.

Eight Christchurch practices fell into that category, she said. They are Freedom Clinic; Kingdom Clinic; Lincoln University Student Health and; Piki Te Ora Christchurch; Te Rawhiti Family Care; Union Community Health Centre; University of Canterbury Health Centre; and Woolston Christian Medical Centre.

Lianne Dalziel said the number of practices taking up the new funding nationwide is 27 per cent higher than estimated, with first year costs expected to be $2.4 million higher than anticipated.

"The government is able to accommodate this higher investment within the current Primary Health Care Strategy budget," said Lianne Dalziel.



Low cost access payment effective from 1 October 2006

A low cost access payment for Primary Health Organisations (PHOs) and their practices that meet and maintain low fees thresholds will be introduced from 1 October 2006.

Those PHO practices that charge very low fees typically serve high need communities. The low cost access payment is a way to support, encourage, and reward PHOs and their practices that, in order to deliver on low cost access to primary health care and reduce health inequalities, have forgone revenue from patient fees.

Why support very low cost access?

This initiative is designed to:

* provide extra support to Primary Health Orgainsation (PHO) practices that charge very low fees. This is expected to be about 15 per cent of PHO practices (166 practices) serving around 615,000 people.

* recognise that the eligible practices typically serve communities with high health needs who do not have the income to support higher fees

* provide extra funding in return for PHOs and their practices agreeing to maintain fees within the fees thresholds. Most PHO practices charge around $26 for adults

* recognise the extra effort involved in providing services to concentrated high need populations and making the aims of the Primary Health Care Strategy real for those communities

* keep fees low for people who can least afford primary health care and improve health outcomes for those likely to have the worst health. (Sixty-eight percent of the people expected to benefit from this initiative are Maori, Pacific or living in areas of high deprivation.)

Eligibility criteria for low cost access payment

Eligibility for the low cost access payment will be open to all PHOs/practices currently charging or prepared to reduce their fees for standard consultations to the thresholds specified below:

* zero fees for children 0 - 5 years

* $10 maximum for children 6 -17 years and

* $15 maximum for all adults 18 years and over.

Interim PHOs/practices that have not yet received increased capitation payments for adults 25 - 44 years will be eligible for the payment for their enrolees in other age groups, provided that they meet the fee thresholds and the DHB is satisfied they have not unreasonably increased fees for the adults 25-44 years. However, they will not be eligible for the low cost access payment for the 25-44 year age group until 1 July 2007.

As well, the PHO must meet two pre-requisites:

* it must have signed the latest variation (variation 4 of version 17.0) of the PHO Service Agreement by 6 November 2006 and

* it must be participating in the PHO Performance Management Programme, or as a minimum, have obtained DHB sign off to its establishment plan for the PHO Performance Management Programme and participate in the programme no later than 1 July 2007.

The value of the low cost access payment

The low cost access payment will comprise an individual practice component and a “whole of PHO” component.

The individual practice component will comprise a 15 percent increase on First Contact capitation funding rates at non High Use Health Card rates for each PHO practice that meets the low fee thresholds. This is equivalent to an extra $4.15 per notional visit for all enrolees 6 years and over and an extra $5.80 for children under 6 years at 2006/07 rates. This is the major portion of the low cost access payment and PHOs will flow it through to the eligible practices.

The whole of PHO component will comprise a 15 percent increase on Services to Improve Access funding for PHOs where all their practices meet the low fee thresholds. PHOs will have flexible use of this portion of the low cost access payment so long as its use is related to implementing the primary health care strategy including reducing health inequalities, and subject to DHB approval for transparency and accountability purposes.

Adjusting the fee benchmark over time

As the low cost access payment will be calculated as a percentage of the First Contact and Services to Improve Access funding, the value of the low cost access payment will be adjusted annually in line with the adjusted base. As well, the low fees threshold (that is, the maximum fees that can be charged to be eligible) will be annually adjusted to maintain value by the same percentage as the capitation base adjustment.


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