New funding system inequitable - NZMA
DATE: Tuesday, 1 October 2002
SUBJECT: New funding system inequitable - NZMA
The Government has missed an opportunity to introduce a fairer system for funding primary health care, says the New Zealand Medical Association.
The NZMA supports the aims of the Government's Primary Health Care Strategy, and welcomes the extra funding being allocated to primary care in New Zealand.
"However, the access formula, which is being rolled out in five areas of New Zealand, will lead to inequities across the country," says the NZMA's GP Council Chair Dr Tricia Briscoe. "Getting cheaper primary health care will now depend more on where you live, rather than your level of need,"
Four Primary Health Organisations (PHOs) are being established today, in the West Coast, Hutt Valley, and Gisborne. They join two existing PHOs in South Auckland. People enrolled in these PHOs (with the exception of West Coast) will be entitled to a higher level of government-subsidised primary health care, which will be free in some cases. These PHOs are in areas with high levels of Maori, Pacific Island and low income populations.
"While people in these areas will benefit from being enrolled in the PHOs, those with equally high health needs in other parts of the country will not receive improved access to health care in the short- and possibly medium-term. Studies show that as many as 45 percent of people with high health needs and low incomes will miss out on this increased funding.
"As well, people with high incomes who live in the PHO areas will be able to access the cheaper services. It has been estimated that as many as 20 percent of people in prospective PHOs which will qualify for the access formula are not in the Government's target low income/high need group," Dr Briscoe said
"The NZMA fully supports the concept of improving access to primary health care and, to that end, we support the alternative proposal developed by the Independent Practitioners Association Council. This proposal is based on targeting those most in need, no matter where they live. We believe it would be a much fairer option, and it meets the Government's policy objectives."
The new arrangements are transitional and it is intended that all New Zealanders will eventually get improved access to primary health care. However, this is planned to be an 8-10 year process, and the NZMA has serious concerns about whether the increased funding will continue to be made available, particularly if the government changes. If the funding does not continue to increase, these inequities will become entrenched.