A sick joke: Why GP fees need curing
Docs call for change to system that sees $50 difference for 15-min appointment. By Susan Edmunds.
DOCTORS say a fairer system is needed to determine how much a basic visit to the GP will cost.
A survey of the cost of a GP appointment this week shows big differences from more than $60 for a 15-minute consultation, while others even within the same city ask only $10.
In some parts of the country, such as Rotorua, there are free doctors’ visits for young adults.
Royal New Zealand College of General Practitioners president Tim Malloy said the cost of a basic consultation for an adult patient would generally be somewhere between $50 and $75, although how much the patient was charged depended on the level of state subsidy the doctor received.
When you enrol as a patient with a doctor who is part of one of the country’s 32 primary health organisations the GP gets subsidies for your care. About 30 per cent of the population is enrolled with about 300 GP practices which operate under the ‘‘very low cost access’’ scheme.
The Government provides more funding to these doctors, operating in areas where the local population is made up of 50 per cent or more patients classified as ‘‘high needs’’. They must also agree to keep fees to a maximum $12 for teenagers and $18 for adults.
Malloy said the system was problematic because people could be wealthy but living in a more deprived area while about 44 per cent of all ‘‘high needs’’ patients are enrolled with a GP practice that is not part of the VLCA scheme.
A Ministry of Health survey found one in nine New Zealanders are not getting GP care that they need because they cannot afford it.
‘‘For the most part the cost is the single most important variable for people who are deprived – beggars cannot be choosers,’’ Molloy said.
Auckland woman Amy Duncan said she limited visits to keep the cost down. ‘‘I won’t go to the doctor unless absolutely necessary. I usually take a list of things I need to discuss with the doctor just so I feel like I’m getting my $56 worth of a 15-minute appointment. My doctors are very strict on being 15 minutes only, CHRIS SKELTON / FAIRFAX NZ they will even book you in again if you need to go over that 15 minutes and charge you another $56.’’
She was considering moving because $56 was about half what she earned in a day.
‘‘The only reason I haven’t yet is because I’ve gone to the same GP since I was four and I feel comfortable there. I have found another GP not too much further that is $41 an adult visit and they’re also open seven days a week, only closed on Christmas. I went there once and they were great so I will be having my records transferred when I next need to see a doctor.’’
Health Minister Jonathan Coleman said he was working on ways to better target funding to high-needs populations, without making others pay more.
He had received advice that showed more than two million patients would have to pay higher fees to support lower-cost access for the 700,000 low-income patients who do not qualify for the cheapest access. ‘‘I will not be making any changes that result in some patients paying more than they currently do.’’