Some Christchurch GPs charging $70 per visit

Thursday, 11 July 2024

GPs say patient fees must go up if government funding does not match their rising costs.

Rising fees at general practices are sparking concerns for patients already on the “breadline”, with some GPs now charging $70 per visit.

Last month, GPs rejected the Health New Zealand – Te Whatu Ora proposed capitation funding increase of 4%, saying practices needed to increase patient fees by 7.7% to keep up with inflation.

That rejection triggered a consultation period, with some GPs increasing prices in the meantime.

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General Practice NZ chairperson Bryan Betty said consecutive governments had promised health reform, but it was yet to be delivered.

“Government funding will be the single biggest issue in the health system in the next two to five years.”

Megan Shaw has often had to prioritise food or power over seeing her GP.

The flow-on effect would be higher patient fees, Betty said.

Megan Shaw suffered from mental health issues and should see her doctor at least once a month, but could only afford to go three times a year.

She was on a low income benefit, worked two cleaning jobs, and volunteered at a community op shop.

She said she often had to prioritise other costs over seeing the doctor. “Food and power are more important than my health,” she said.

“I just don’t have the money to be going to the doctor.”

Each time she saw her GP it cost $20, and each prescription now cost $5.

Rising GP fees will put more pressure on hospitals and after-hours clinics, General Practice NZ chairperson Bryan Betty says.

“It all adds up,” she said, and was now coming at the cost of her mental health.

“[My doctor is] basically the only one that I can turn to.”

Betty said rising GP fees also put pressure on after-hours clinics and emergency departments, as patients who could not afford to see their primary doctor ended up waiting until health issues became acute before seeking help.

“You have to look at the bigger picture here. If you allow your system not to function and have higher patient costs … then you have bad long-term health outcomes.

“The average price across New Zealand to see a GP is already $55.”

From July 1, there will be a $5 charge at the pharmacy for each new prescribed medicine.

However, Betty said practices particularly in high-risk areas are absorbing or writing off their costs, running at a loss, or GPs are not paying themselves to pay other staff.

Increased funding from Te Whatu Ora was not guaranteed and the Government may choose to invoke a “compulsory variation” which would see the 4% decision being final.

At that point, there would likely be more price increases, Betty said.

The Press contacted several doctors’ surgeries across Christchurch, and many had put up prices in the last six months because of the increasing costs.

One had raised its fees to $63 on July 1, while The Doctors Christchurch South has increased charges for enrolled patients to $70.

Kerri Nuku of NZNO is concerned people are having to choose between putting food on the table and taking care of their health.

An email from the practice said the price rise was necessary “due to the widening gap between Government funding for primary care and the actual cost of delivering high-quality health services”.

Phoenix Healthcare national health manager Chenoa Walker said they were disappointed by the Government’s decision and would be reviewing their fees at some point in the future because the cost of running the practice keeps going up.

“Staff costs, insurances, maintenance – everything has increased.”

GPs receive a set amount of government funding for each enrolled patient per year, with extra subsidies for children and high needs populations. Practices that are part of the Very Low Cost Access (VLCA) scheme are not allowed to charge more than the maximum fees set by the Government (currently $19.50 for adults), while non-VLCA practices have to charge fees within a set guideline.

If a GP wanted to increase its fees by more than the annual percentage increase approved by the Government, this could trigger an onerous fees review process.

New Zealand Nurses Organisation (NZNO) kaiwhakahaere (manager), Kerri Nuku said GP price increases were already hitting people living on the breadline, and would get worse.

“The official data doesn’t pick up the statistics of the people choosing to put food on the table rather than prioritising their health.

“People are dying because they are not accessing healthcare early enough. We see more complicated health outcomes because they are presenting later for things like smears.”

When people are being told not to come into the doctor if they can’t pay in advance, “we are perpetuating the hardship” Nuku said.