NZRGPN Chair questions government motives in funding breakdown

New Zealand Rural General Practice Network Chair Dr Tim Malloy has questioned why the government would impose on the sector a condition it knows to be unacceptable to general practice at a critical point of the primary healthcare strategy. It has done this at a time when the sector is trying hard to work together to reduce health disparities.

His comments follow the breakdown of the contract negotiations between DHBs and PHOs in respect of additional funding for 45 – 64 year olds. The funding, worth approximately $110 million, would have made visits to GPs cheaper for people in that age group who were not already subsidised by the government.

“The current PHO contract is acceptable, although not ideal,” said Dr Malloy. “It is how we have progressed implementation of Primary Health Strategy over the past three years, including previous funding rollouts. On this occasion the principle of fee control by government has not been negotiable. The PHO Service Agreement Amendment Protocol Group (PSSAP) process disempowers GPs as it negotiates processes between PHOs and DHBs without GP involvement.”

Dr Malloy says rural GPs would have been prepared to roll-over the current funding allocation for 45 – 64 year olds in interim-funded PHOs under the existing contract. “However, DHBNZ has indicated that without fee control they are not prepared to release the patient subsidy for this year.

“This is neither fair to the affected public nor to the integrity of the general practitioners trying to provide quality cost-effective service. For many of our rural practices viability is highly fragile. General Practice is a private business with all the responsibilities and financial risks this involves. In order to stay in business practitioners must be able to determine the costs and pricing structures unique to their business. For example the cost of locums is dictated by the international market place from where they are sourced and can fluctuate significantly. We need to be able to respond to these drivers as we see fit.

“If we are to be able to sustain an already depleted workforce we need less pressures on our business, not more. General practice both urban and rural will stand together on this most important of issues. (CONTINUED)

“Why, given that we confirmed we want to pass the subsidy in full on to our patients, just as we have done in the past, has the government chosen this tack?”

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