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Recent increases in family doctor’s fees are just the latest symptom of a health system in crisis and years of chronic government underfunding, according to one local GP.
Dr Tim Malloy, who is director of Wellsford-based Coast to Coast Health Care (CTCHC), said the August 1 increase, which saw fees for adult non-CSC cardholders rise by $10 to $29.50 at CTCHC’s eight clinics, was down to the government, not individual practices.
“The difference between the actual cost of seeing a patient for 15 minutes and the subsidy we receive is what the patient pays, which for years has been $19.50,” he said.
“Because the government won’t change the capitation to match that deficit, we’re getting no increase.
In fact, we’ve been making a loss every year for the last 20 years in subsidies.
“In our particular funding formula, government prescribes how much we can be subsidised for and how much patients can pay us. We have no flexibility on what we can charge.
“And the government this year decided the balance could be made up by people without a CSC card, those who are better off, by $10, as a proportion of the total.”
Malloy said he understood that the change would hit people on lower wages hardest.
“None of us want to be charging patients more than we have to. The ones compromised most are those who are employed but on a minimal wage and I feel uncomfortable for them, because I know that’s a burden,” he said. “But unfortunately it’s a consequence of the black-and-white system that says if you’re that side of a line you pay, or if you’re on the other, you don’t.”
Malloy said the government funding model was complex, outdated and causing the GP network to fail.
“We’re not a National Health Service, we’re not fully funded by the state at all,” he said. “We’re restricted by the extent they subsidise, which has eroded over time. The sad thing is, it’s a joke, but it’s not funny.”
He said no government had done more than superficial tinkering around GP funding, to the point where any changes now would be too little, too late.
“I’ve been involved in advocacy for 30 years, I’ve seen 17 Ministers of Health, on why we need to be investing in the medical workforce,” Malloy said.
“We’re now at the point where it’s an absolute crisis. The health service is about to collapse.
“There are pockets that are reasonable, but there are places up and down the country, and as close as Northland, where you simply can’t get to see a doctor.
“None of us want it to be this way, but it’s just if people won’t listen year after year, ultimately there’s a price to pay, and we’re seeing it already with poor outcomes in morbidity and mortality. We know what good looks like, and this isn’t it.”
Malloy said radical change was needed in the way healthcare was funded and provided in New Zealand if the system was to survive.
“We have to develop a system that acknowledges we’re a small population spread over a large area, and be innovative,” he said.
