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Health And Disability System Review Highlights Greater Need For Sustainable General Practice

The interim Board of GenPro, the General Practice Owners Association, whose objectives include supporting the productivity and efficiency of the New Zealand health and disability system, have today welcomed the focus on addressing inequalities and moving services from secondary to primary care settings as set out in the recommendations of the Government’s Review of the Health and Disability System. However, it has also warned of the potential for General Practices to be left to “fend for themselves” in the post-review health system.

Dr Angus Chambers (pictured), interim Deputy Chair of GenPro, said “It is good that the wait for the review’s recommendations is over, and there is much in the report which is positive, including the acknowledgement that the health system needs additional funding, but proposed structural system changes mean that it will become more important than ever for General Practice business owners to have strong national representation”.

GenPro’s interim Board warns of some potentially significant unintended consequences of the recommended move to local contracting. “History tells us that there is a significant risk in moving away from nationally consistent service contracts and the impact that a post-code lottery will have on the principle of universal health care - where every New Zealander should be able to rely on a consistent, high quality service. Whilst GenPro sees a clear advantage in developing contracts through direct engagement with those that actually provide the service, we should not underestimate the importance of essential ‘nationally consistent services’ and we should ensure that individual General Practice business owners do not have to fend for themselves directly with larger District Health Boards” Dr Chambers said.

The Review’s recommendation that Primary Care funding be ring-fenced also prompts words of caution from GenPro. Dr Chambers states that ”Ring-fencing of primary care funding does not feel like the way to encourage investment in a sector whose growth will be essential to securing the system benefits and health outcomes that the Review anticipates. Too often, ring-fencing becomes a target rather than a minimum – and a target that can be manipulated through accounting tricks which would go completely against the spirit in which it is intended”.

GenPro separately notes that there have been calls for a separate funding review following the release of the Review’s recommendations but says that further reviews are not needed and will simply paralyse the system for even longer - and that will not help General Practice sustainability according to GenPro’s interim Chair, Dr Tim Malloy, who says “We have had review after review of health funding and another review is only going to tell us what is already widely acknowledged – that the health system is underfunded overall and that more funding should be targeted to those with higher need to support their health and wellness and keep them out of hospital. It is time for the implementation of previously accepted recommendations to appropriately fund General Practice, rather than wasting time on further analysis”.

Since its launch in April 2020, GenPro’s membership has grown consistently and it now welcomes the opportunity to work with the Government, Ministry of Health and sector colleagues to support the improvement in health outcomes and system sustainability envisaged by the Review’s recommendations.

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