University of Otago academic health and business leaders consider it timely for a debate about funding primary healthcare services including the possibility of the Government salarying all GPs and abolishing patient fees.
In an editorial in the latest issue of the New Zealand Medical Journal today, Pro-Vice-Chancellor of the Otago Business School, Professor Robin Gauld, together with colleagues Dr Carol Atmore, Associate Professor Jo Baxter, Professors Peter Crampton, and Tim Stokes question whether patient charges support a healthcare model fit for the future.
Professor Gauld says it is timely for such a debate given the current review of the health system by Government. Currently, New Zealanders pay to visit a GP who are mostly private business owners, while all public hospital services, including outpatient and emergency services, are free of charge. The combination of fees to see a GP alongside free public hospitals is unusual globally.
The Ministry of Health has highlighted a need for equity in health service provision, to improve services for increasing numbers of older people and those with chronic diseases and to focus more strongly on primary and community care in order to reduce pressure on hospital and specialist services.
“Undoubtedly, and in order to achieve these aims, the review will need to confront how New Zealand primary care and general practice are funded, including whether a break with the past and a completely new model is needed,” the editorial states.
An alternative proposed by the academics is full funding for general practice services. One option would be for the Government to fully fund general practice services, while a more radical alternative would be for government to salary all GPs.
Professor Gauld says there is growing, anecdotal agreement within the GP community that cost has become an unacceptable barrier for many people accessing general practice services in New Zealand. The highest rates of barriers to GP services are among Māori, Pacific, and those living in socioeconomically deprived areas.
Currently, people who cannot afford to access primary care GP services need to seek alternatives such as free hospital emergency department treatment, but in future there could be a system where funding follows the patient into freely accessible community-based services focused on personal and whānau care.
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Professor Robin Gauld
Pro-Vice-Chancellor and Dean, Otago Business School,