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Equity Adjuster And Initial Steps For Comprehensive Care Teams Announced Today A Step In The Right Direction

In a statement released today Minister of Health Dr Ayesha Verrall and Associate Minister of Health Peeni Henare gave further detail on the long-awaited equity adjuster and comprehensive care teams promised in Budget 2022.

General Practice New Zealand (GPNZ) understand the equity adjuster investment is effective 1 January 2023 to 30 June 2024, and will be targeted to Māori and Pacific providers who will receive $80 per person per annum and to mainstream general practices with an enrolled population of more than 50 per cent Māori and/or Pacific who will receive $40 per person per annum.

GPNZ Chair Dr Bryan Betty says the equity adjuster approach once more demonstrates just how far from fit-for-purpose our current funding model is.

“We can’t keep applying band aids on our gaping wound. It is well-known the current funding formula doesn’t not consider ethnicity, socioeconomic status, and age, and it does not fund our sector to a level where we can start to address our persistent and significant equity and workforce challenges.”

In addition to the equity adjuster, the first steps to establish comprehensive care teams were also outlined. This will see kaiāwhina, physiotherapists, pharmacists, care coordinators (navigators), and paramedics in some rural areas, working together as a closely integrated primary care team.

The first phase will introduce 85 clinical FTE and 107 kaiāwhina FTE across the country, with comprehensive care teams being established in the first established localities plus areas where system pressures are being felt most acutely – Counties Manukau, Northland, Auckland, Waitematā and Bay of Plenty.

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GPNZ chief executive Maura Thompson says today’s announcement could seem underwhelming, though it is understandable that limited resources are targeted in this first release and it is good to finally see some progress. But what really counts is what comes next.

“There will be various hui over the coming fortnight, with the goal of getting these roles deployed to the frontline as quickly as possible. We can’t afford any further delays, which includes our expectation of staying on time with the next phase expected in May.”

GPNZ will be working with PHOs to assist with contracts, which are expected to have flexible options for how people will be employed to the roles.

“We’ve just had the initial briefing and there could be similarities with the Access and Choice programme where people may be employed directly by a provider and working across one or two other practices or the contract could be held by a PHO or similar,” says Maura.

Dr Betty said we saw a well-intentioned step in the right direction today, but one that is ultimately still flawed.

“The initiatives demonstrate some recognition of the challenges, but we need a better overall approach - we don’t want to keep attempting to plug gaps with niche initiatives.

“We need to get our base funding model right, with urgency, so we can truly address equity and workforce. The longer we keep tinkering at the edge with an outdated funding model the further away the shift towards wellbeing and equity envisaged in the Pae Ora legislation is.”

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