City GP costs soar

Patients are paying more for routine GP appointments as practices across Christchurch increase their prices to cover rising costs.

The Press contacted multiple general practices across the city and most had recent price increases of $2 to $5 for enrolled adult patients (with no community services cards).

Age Concern Canterbury chief executive Greta Bond said she was worried that the increases would put people off seeking timely treatment. “Having a good relationship with your GP as a first port of call is vital, particularly for elderly people and, if you can’t afford that, then it has a really bad impact on ongoing health,” she said. “Older people and other people on low incomes might live with symptoms for longer and put themselves second, but that can lead to greater acuity.”

General Practice New Zealand chairperson Dr Bryan Betty said GPs had to raise prices because government funding had not kept pace with rising costs.

The price increase for enrolled adult patients who did not hold a community services card (CSC) would likely be happening across the country, Betty said. “General practice in New Zealand operates on very thin margins, so it doesn’t take much to tip it over and with substantial increases in both labour and costs in running practices, government funding doesn’t fully account for that.”

The rising cost of routine appointments comes in the wake of steep price increases at Christchurch’s after-hours clinics and increasing pressure on Christchurch Hospital’s emergency department (ED). The hospital was seeing more than 400 patients on peak days.

Ferrymead Medical Centre put its prices up last month from $50 to $55. Te practice had not had an increase in two years.

Village Health Medical Centre went from $54 to $58 last month, while Doctors on Cashel went from $54 to $57 two weeks ago.

The Government’s 5% funding increase for GPs that came into effect on July 1 was at least 9% less than what was needed to keep services going, GP leaders previously said.

In a joint letter to Te Whatu Ora, the General Practice Leaders Forum (GPLF) said a 5% increase in the fee paid to GPs would not address the emergency crisis the sector was facing.

Te Whatu Ora’s group manager for primary health care system improvement and innovation, Adeline Cumings, said an additional investment of up to nearly 9% had been provided to CSC, very low-cost access and zero fees for under 14s to keep the patient co-payment levels at their existing rates. The health authority was also investing $102 million over three years with its comprehensive primary and community care teams, $31m in funding towards the nursing work force, $86m over four years to help address equity in the capitation formula and $10.5m in immunisation services.

“Te Whatu Ora does recognise that the current national capitation-based funding model for primary care is not fit for purpose,” Cumings said.

It was establishing a priority work programme to address it, she said.

Government funding was given to different practices depending on the structure of the practice and the patients enrolled. After hours care was partly funded through the national PHO Services Agreement and ACC.

Separate to that funding, Te Whatu Ora had a direct contract with the Christchurch 24 Hour Surgery and was providing funding to Riccarton Clinic to support pressures, Cumings said. The details of that funding was commercially sensitive, she said.

Riccarton Clinic owner Angus Chambers said the extra funding to prop up the after hours service and support a “borderline financially sustainable” service until September was only a quarter of what was asked for. He said it was “pretty clear” the Government did not value them. The clinic was forced to increase the cost of its after hours service to $120 for non-enrolled adult patients, up $16 since last August.

Ministry of Health chief medical officer Dr Joe Bourne acknowledged it could be difficult for people to access healthcare, and said “the ministry supports the work that Te Whatu Ora is undertaking in this space.”

“The Pae Ora strategies announced [on Wednesday] are aimed at addressing longer-term issues including improving access to healthcare particularly for priority groups and the ministry will be working with Te Whatu Ora to help implement these strategies,” Bourne said.

Betty said there was a lot more work general practice could be doing to ease pressure on hospitals if it was resourced to do more.

“We have seen in the past often a lot of work has been put out from hospitals into general practice but funding hasn’t followed. General practice is expected to do more and more in terms of that delivery but often that resource doesn’t follow out into the practices, that’s problematic.

“Cost barriers are something we need to reduce in order for patients to get access to medical care in the community,” Betty said.

Additional reporting by Joanne Naish.

Other options, if not urgent:

■ Consider a virtual appointment with a clinician via a device such as your phone, laptop or tablet.

■ Seek free health advice from Healthline on 0800 611 116.

■ Visit a local pharmacy for advice on overthe-counter medications and treatments including pain management. Many Canterbury pharmacies can also provide free medicines for eligible patients such as children with minor health conditions such as diarrhoea and eczema.

■ Many GPs can issue repeat prescriptions over the phone or online.