Photo: Unsplash / RNZ
Health New Zealand has a plan to relieve pressure on primary care services - but patients will have to pick up more of the cost for now.
A survey released this week by the General Practice Owners Association (GenPro) found nine out of 10 clinics were increasing fees due to rising costs, high patient demand and staff shortages.
Te Whatu Ora's clinical director of Primary and Community Care, Sarah Clarke, conceded the 4 percent funding increase this year for enrolled patients (capitation funding) fell short.
"We absolutely acknowledge that the cost pressures faced in general practice are growing and that demand for services is also growing, and that the uplift in funding that we were able to provide this time was not going to meet the total revenue increase of 5.88 percent that was calculated by an independent estimate of general practice cost growth."
Health NZ had "mitigated" this by allowing general practices to raise their fees by an average of 7.76 percent, which increased their total revenue to 5.88 percent.
Dr Clarke, who works at Kaitaia Hospital, said primary care, general practice and Health NZ were all working "in a fiscally constrained environment".
"General practices are businesses, and they need to be solvent in order to carry out their businesses and that means of course they need to be able to increase their rates or fees to keep their business running."
Primary care was "the cornerstone of the health system", seeing 80,000 patients every day, Clarke said.
"We know it's tough out there, but we do have a plan."
That included "re-weighting" capitation funding - the annual payment based on the number of patients enrolled at a practice, irrespective of how many appointments they have.
Research commissioned by GenPro found patient attendance rose than 20 percent in the 10 years to 2022.
"At the moment, the weighting doesn't really push the money where the need is, so we need to make sure that the money is going to the right places," Clarke said.
The Primary Care Development Programme was tackling the pressure on GPs in several ways:
- Working with ACC on new models for urgent, unplanned and rural care;
- Boosting GP workforce with record 239 doctors enrolled in specialist training this year, paying trainers, offering financial incentives for rural placements;
- Recruiting from overseas;
- Working with telehealth providers and allied workforces on "new ways of working".
GenPro has calculated that general practices would have received an extra $102m a year if Health NZ had followed the agreed independent cost analysis.
However, they argue the real cost of providing care is much higher.
A report commissioned by the previous Labour government and released in 2022 called A Future Capitation Funding Approach showed GPs would need over $600 million more each year to address the estimated 70 percent of unmet need.