Media release from health minister Pete Hodgson

More families are set to benefit from free doctor's visits for their children aged under six following an $8.25 million investment by the Labour-led government, Health Minister Pete Hodgson announced today.

The funding will be rolled out from 1 January and is a result of Labour's agreement with New Zealand First to work towards the objective of free health care for under sixes.  It will be made available each year to practices that commit to providing free care for children under six.  

"The Labour-led government believes that all children deserve the best possible start in life," Pete Hodgson said.  "We don't want any parent to think twice about taking their young child to the doctor because of how much it costs.

"The majority of general practices already charge no fees for children under six and we want to make sure those practices are getting the support they need.  We also hope that some practices charging very low fees will see the funding as extra incentive to reduce their fees to zero."

61 per cent of general practices currently charge no fees for children under six, making the median fee $0.  Average fees do vary across the country, but at a national level the average is still low at $5.  

The under-sixes initiative is one part of the Labour-led government's major drive to lower the cost of primary health care for all New Zealanders.  As a result of the seven year, $2.2 billion Primary Health Care Strategy, the cost of seeing the doctor has fallen by around half and standard prescription charges have been reduced from $15 to $3.

This has resulted in significant annual savings for New Zealand families, with the average family health bill falling from $940 to $440 a year.

The announcement of today's initiative is also part of a wider cross-government programme focussing on the needs of young children, including 20 hours free early childhood education and the B4 school health checks announced just last week.  

Pete Hodgson thanked NZ First for their partnership in bringing this important goal closer.

Questions and answers

What percentage of practices currently provide free care to children under six? Currently 61 percent of practices provide free standard consultations to children under six - and as a result of the under sixes initiative we expect the percentage to increase significantly.

As a result of this scheme, will all practices provide free care for under sixes? No.  This is a voluntary scheme.  In order to receive this extra funding, practices commit each quarter to providing free standard consultations to children under six.  Some practices will choose not to participate - but we believe a high proportion will so that families of young children will have access to a practice that does provide free care to under sixes.

What happened to the previous government's policy to introduce a free under sixes policy? On 1 July 1997, a general medical services (GMS) subsidy of $32.50 for children under six was introduced.  Although widely known as the "free under sixes policy" at no stage did all practices charge zero fees to under sixes.  Practices retained their right to set their own fees.  However, a high proportion did provide free standard consultations.  

As a result of the extra investment by the Labour-led government, which is available only to those practices that commit to providing free care to under sixes, we expect a higher proportion of practices to provide free standard consultations.  

Unlike the previous government, this government has annually adjusted capitation funding to PHOs to maintain value so that the current funding on a per notional visit basis is $39.70 - and now PHO practices who commit to providing free care to under sixes will receive an additional $6 per visit - bringing the government's contribution up to around $45.70 per notional visit.  

What did Labour and New Zealand First agree after the election about free primary health care for all under six year olds? The Labour-led government's Confidence and Supply Agreement with New Zealand First states it will "actively work towards the objective of having free primary health care for all under six year olds".  This Under Sixes initiative demonstrates a real commitment from Government to achieving free primary care for under sixes.  In return for providing this extra funding, the Government requires a commitment from practices to provide free consultations for children under six.

Will after hours visits for under sixes be free too? The under sixes initiative applies to standard consultations during normal hours only so practices participating in the Under Sixes initiative can still charge for after hours consultations (that is, after the usual hours the practice is open) for children under six.

Apart from not charging for standard consultations for children under six, are their any other requirements for practices to receive this extra money? As with the Very Low Cost Access initiative, a prerequisite of eligibility for the Under Sixes payment will be that the PHO is participating in the PHO performance programme.  One of the current PHO performance measures relates to immunisation (children fully vaccinated by their second birthday).  This measure includes a high needs indicator to focus on reducing inequalities.  Another prerequisite is that the PHO has signed the latest version of their PHO Service Agreement.

What is the relationship between the Under Sixes initiative and the Very Low Cost Access initiative? PHO practices that participate in the Very Low Cost Access scheme already provide free care for children under six - in return for 20 percent increase on capitation (from 1 October 2007)

Very Low Cost Access practices receive a higher rate than those practices participating in the Under Sixes initiative because in addition to free care for children 0-5, they have to commit to very low fees for all other age groups - $10.50 for children 6-17 years and $15.50 for adults 18 years and over.  PHOs receiving Very Low Cost Access payments cannot receive the Under Sixes payments as well.