Ministry opts for compulsory change to GP funding despite 75% PHO opposition


Ministry opts for compulsory change to GP funding despite 75% PHO opposition

NZ money
The Ministry of Health is determined to introduce changes to general practice funding in time for next month’s payments
The Ministry of Health is pushing ahead with its compulsory variation to general practice funding rates without consultation, despite more than three


Why do successive governments want to kill Primary Care?

This just screams to young doctors "DON'T DO GENERAL PRACTICE"!!!

Where the hell is the College in all of this???

We have known for years that the funding increases did not adequately address the costs associated with compliance. Some of those costs were even engineered by our own College. We have also known that the increases did not adequately address the rate of General Inflation. We have certainly known that the increases have not addressed medical inflation. Nothing was done for 15 years. Then when Government wanted to roll out the CSC funding, instead of using this issue to hammer home the point, decline the policy unless it was associated with a real increase in funding that a) compensated for the costs of the policy, and b) compensated for the years of neglect, PSAAP threw away this opportunity in their endeavours to give their real masters what they wanted even if it came at the expense of sustainability of General Practice.

Now all of a sudden they (PSAAP/PHA) want to make this an issue when the bird has flown? PHO's seem to have been hell bent on destroying the sustainability of General Practice - either deliberately or because of incompetence (and I am not sure which is worse). We should not forget the role of Ministry in all of this either. They have been the masters of the process and have not given any thought to the consequences for Practices and for the future. They have been squeezing the life out of General Practice. I am not giving Ministry credit for doing what they should have been doing all along, I am pointing out that they haven't ever done this before and PSAAP has not made them maintain the value of the funding or compensate for compliance costs. Between the two they have made General Practice virtually unsustainable. It does not matter who is expected to provide the services in the future when it is not financially viable - and the alternatives will cost even more. And then we get Scarecrow from the Wizard of Oz running the whole show.....

Question to Jeff Lowe.

So Jeff, where to now? Does this mean General Practice has the right to waive any restriction we have on increasing our fees also as the Government seems to treat any current agreement with absolute contempt? The coal face does not want "symbolic" protests, we want to take real action that will save our practices. We are sick of getting kicked annually. We are sick of seeing our SMO colleagues get huge inflation adjusted increases PLUS steps year upon year.

No offense Jeff but some of us do not enjoy the heady co-payments you do in the leafy Wellington suburbs, these Government actions hit a lot, lot harder for some of us compared to others.

We want real and meaningful representation from our representatives, we want action.

Brian you’ve got your facts wrong with respect to the PHA. While I agree that the primary care representatives “threw away” the opportunity we had last year to address the chronic underfunding of General Practice, it is“not all of a sudden” that the PHA “want to make an issue” with respect to this matter. The PHA did not support the CSC deal for a number of reasons but the majority of PHOs were in  favour as were the 2 GP reps. 

I think you should be questioning your PHOs position and your GP reps position rather than attacking those of us who are standing up for General Practice.

Capitation was introduced in 2004. The Agreement stated that "Government will maintain the value of the funding". It is there in black and white. At NO point (until this year at least) has the annual increase in capitation met let alone exceeded the rate of General Inflation. Statement of fact. At no point has PHA or PSAAP made representation about this fact, on the contrary they have agreed that Ministry has "maintained the value of the funding". By what measure? Please explain. We won't even get in to a discussion around medical inflation (which has been consistently around 5 - 6% pa over the same period) or compensation for increasing compliance costs about which PSAAP and PHA have done exactly nothing. I was not having a go at you Angus but at the organizations of which you are a member.

As far as South Canterbury is concerned we have no PHO. We have no PHO because we got rid of it because it was inept. What we do have is a Primary Care Alliance. This is made up of Primary Care representatives and the South Canterbury DHB. I know all about it, the funding available, funding increases and GP representation - I am the Chairman. I would doubt very much that there is any region in NZ where there is a better working relationship between the DHB and Primary Care. We have banged heads and we have worked things out. We have not rolled over and played dead.

SCDHB and PCA are limited by the funding we receive from Government and the restrictions Government places on how we can spend it. We work with our DHB to ensure we avoid an "overspend" and to get the maximum "bang for buck" across all sectors where possible. Tell me which other DHB does not have a deficit? We work hard at keeping our Primary Care Providers informed. We do not "top-slice" any of the Capitation ensuring the full amount is passed on to Providers. We even tried to get a fairer contract for Providers but were stymied by Government and PSAAP (not by our DHB). Thanks for that. I know this because I was negotiating the contract. Just saying. Oh, also facts. Do you want to see the evidence?

Wrong Angus

Both Provider representatives did not agree to waive the consultation period. Nor, as far as I am aware did the other three PHO negotiators.  And consultation is the wrong term for this - it is a prescription notice. There was no opportunity in the "consultation" process to alter the outcome. 

So Mark, Jeff and Angus... as our representatives where to from here??! Do we accept this practice killing contempt? Do our representatives roll over and play dead again? Do the country's GPs accept yet again the collective shrugging of shoulders? Watching the ASMS locally kick arse this week leaves me distraught when I read this. We need our representatives to take their lead.

Can you honestly recommend General Practice as a career practice now the Government will no longer adequately financially support the business case???

I think it is ridiculous that people argue who put (or didn't put) the last straw on that broke the camel's back and forget about all the straws that went before it. What about the camel? Do they intend to shoot it and just be done with it? Where will they find another camel? Or do they just intend to get a pack of donkeys and to do the same thing to them?