Family doctor visits have become more affordable for half of New Zealand's population

New Zealand's Ministry of Health has released research that shows Primary Health Organisation (PHO) family doctor visits have become more affordable for half the country's population.

A summary of key findings from five reports shows that before implementation of the Primary Health Care Strategy, there were clearly identified cost barriers to people getting general practitioner (GP) care.

Those most likely to be put off from visiting a GP because of cost were those living in areas of high deprivation, Mâori and Pacific people.

Ministry spokesman Dr Jim Primrose said recent analysis of GP fees has confirmed that visits to Access-funded PHO practices – those with 50 percent or more low-income, Mâori or Pacific peoples on their register – cost significantly less than fees charged by Interim-funded PHO practices.

"The overall key findings show that Access-funded practice fees are lower even for those age groups – school-age children and those aged 65 years and older – for whom Interim-funded PHO practices are receiving similar levels of captitation funding," he said.

"This supports the Government's decision to start implementing the Primary Health Care Strategy by making sure extra funding goes first to those PHOs who serve populations of people facing the greatest financial barriers to care."

There are 73 PHOs covering about 3.57 million New Zealanders around the country. Of these, about 1.08 million can get primary health care from Access-funded practices. However, the total number of people who can get low or reduced-cost care through their PHO practice rises to 2.04 million when the children and older age groups visiting Interim-funded practices are taken into account.

Dr Primrose noted that the National GP Fees Survey carried out in February this year shows that 82 percent of the practices surveyed did not charge children aged under six for standard consultations. Overall, the average charge for these children was $1.59.

This survey also shows that Interim-funded practice fees for 6 to 17 year olds who didn't have a Community Services Card (CSC) reduced on average by about $22 compared with unsubsidised adults in PHOs. For CSC holders aged 6 to 17, the reduction was $24.50.

Extra Government funding became available to Interim-funded practices from 1 October 2003, to help lower costs for children aged 6 to 17. There are now about 422,300 youngsters in this age group who are covered by Interim practices.

From 1 July this year, funding was increased by about $47 million to help reduce doctor's fees in Interim practices for people aged 65 years and older.

Dr Primrose said analysis shows that on average, Interim PHOs reduced fees for their non-CSC holding senior citizens by $23.40. The average fee charged to those over 65 years was $24.65, although there were wide variations in different District Health Board (DHB) areas.

There are more than 339,000 older New Zealanders who can get low or reduced cost care through their Interim practices, and a further 102,000 people aged 65 and over are covered by Access-funded practices.

The February survey also revealed that fees charged in Interim PHOs were on average slightly higher across all age groups than those in non-PHO practices.

As well, the average unsubsidised fee for people aged 65 years and over appears to have increased by 11.7 percent between February and July this year.

One explanation for this is that when PHO general practices notify future fees, they tend to review their current fee, putting it up before committing to it.

PHOs have now agreed to notify any further increases in fees and DHBs are able to set up a fee review committee if they consider any rises are unreasonable.

Dr Primrose said the Ministry will continue to support DHBs as they work with PHOs on reducing GP fees.

"It's important we know what is being charged out there in communities. This is the first time we have been able to analyse in such detail the financial impact PHOs and the Primary Health Care Strategy is having on the pockets of New Zealanders.

"Reduced fees is one measure of the success of the strategy and DHBs will report each quarter on any increased fees that have been notified by their PHOs."

Under the terms of agreement for getting public funding, all general practices have to display their charges where patients can easily see them.