Chronic Underfunding Could Force A GP Fees Hike

Nelson Bays Primary Health (NBPH) is consulting general practices in the Nelson Tasman region about the government’s current funding offer for primary healthcare.

On 20 June, a 20-day consultation opened for primary health organisations (PHOs) to make submissions after PHO membership body General Practice NZ (GPNZ) rejected a funding proposal from Health New Zealand / Te Whatu Ora (HNZ).

HNZ has an obligation to provide reasonable increases through the PHO Services Agreement Amendment Protocol (PSAAP). During PSAAP discussions with HNZ last week, NBPH voiced significant concerns about the proposed funding changes – a mix of nil increases, small increases and variations to the agreement.

Late last week NBPH Chief Executive Sara Shaughnessy invited GP practices in the region to give their feedback on the proposal. Collated, this feedback will inform NBPH’s submission to HNZ.

Ms Shaughnessy says that it is critical that practices are aware of, and understand, the potential implications of the proposed funding increase of just 4%.

She says it’s also important that New Zealanders are aware about what will happen if funding is not increased to 14%, as advised by independent analysts in the 2022 Sapere Report commissioned by the Department of Prime Minister and Cabinet. This widely-accepted advice has never been actioned, with an average of 3% increase each year since 2020.

Ms Shaughnessy says ongoing chronic underfunding of primary health puts GP practice managers in an impossible situation; without adequate funding to maintain their level of services and staffing, practices will be forced to increase patient fees.

“The doctors, nurses, practice managers and other frontline healthcare workers I have heard from in the past few days are really worried about the implications for their patients, and their staff,” Ms Shaughnessy says.

“We know that GP fees are top of mind for so many people and it’s a tough time of year to be facing higher fees.

“Is the government comfortable with putting doctors and nurses in the position of raising fees so they can stay open and staffed? Medical care needs to be accessible when people need it – our primary health teams do everything they can to make healthcare accessible and here we have a new barrier threatening to undermine this.

“The solution, as far as Health New Zealand is concerned, is that general practices should ask their patients to pay more.

“This is putting the burden on families and is really disheartening for hard-working GPs, practice nurses who do so much to help people stay well, get well and live well.

“Their service is immense – they immunise against disease, provide urgent after-hours care, support people for life with chronic health conditions, provide mental healthcare, drug and alcohol additions support, post-operative care, palliative care. They are there for people in their first years – and their last years. And so much more.

“GP practices are a critical cog in a well-functioning health system, preventing people from becoming so unwell they need ED or hospital care.

“Sadly, this is what happens for people when public healthcare gets too expensive. People delay getting medical attention, for themselves or a dependent, and can become terribly unwell.”

Ms Shaughnessy says that Nelson Tasman practices are facing a situation where a $45 appointment fee could increase to as much as $65, should someone need essential ‘extras’ – pharmacy prescriptions, a blood test or surgical procedure such as skin lesion removal.

“There’s not a GP out there who wants to raise fees, because they believe in accessible healthcare and they already play their part in improving accessibility.”

Ms Shaughnessy says she is hugely concerned for the primary care workforce, with increasing numbers of doctors and nurses leaving for better conditions and pay in hospitals or overseas.

“Nelson Tasman used to maintain a lower-than-average rate of turnover, but in the past 12 months it has climbed ahead of the national average – from 13% to as high as 28%.

“It is hard enough as it is and practices are giving it everything they have to meet the demand for their services. People in these jobs are driven by their urge to care and make a positive difference and people’s lives.

“But we need to care for the carers.”

About Nelson Bays Primary Health Trust

NBPH is a not-for-profit organisation that distributes public funds to general practices and provides primary and community health services. In the Nelson Tasman region, NBPH funds 21 general practices to provide more than 15 services that would otherwise be provided in secondary care, such as minor surgery, spirometry testing for respiratory conditions such as asthma and COPD, palliative care services, reproductive health and more.

NBPH funds community health services such as programmes to support the self-management of chronic health conditions such as diabetes, community hospital care in Golden Bay and regional mental health and addiction services.

The PSAAP, funding proposal and wider health sector reaction

Information can be found at:

• Government website (Health NZ / Te Whatu Ora)
• GenPro website – GenPro is a GP membership organisation
• GPNZ press release – NBPH supports this

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