GP anger over minister’s advice to change their business approach

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GP anger over minister’s advice to change their business approach

David Clark
Health minister David Clark says GPs can resolve cost issues through changes to models of care and business models

In what is not a particularly good start to 2019 for general practice, sector leaders find themselves seething over the content of pre-Christmas correspondence with the health minister. Cliff Taylor reports

From the practices’ point of view this issue needs to be addressed, or there will be more unrest in the sector NZMA chair Kate Baddock says GPs a, KATE BADDOCK, NZMA chair Kate Baddock says GPs are concerned and angry at the health minister’s attitude to general practice sustainability


Getting advice about how to run a General Practice from someone who had never run a business beggars belief.

What the sector really needs is equity in funding and representatives that demand it. VLCA needs to be urgently abolished, we need equity with ACC payments and a capitation formula that is fair with respect to demographics and is corrected for the gross underfunding we've had for the last 15 years, nothing less.

Actually Minister, a good start would be just honoring your election promise with respect to funding with one funding system for all rolled out on 1/7/19, if you were a man of your word that would be a good start to your role.


No one should really be surprised by the ministers position.

If it were otherwise we would have seen meaningful attempts to address this issue. The MOH’s advice to the minister last budget  makes no mention of any importance in addressing this - only that there is an expectation in the sector.

The primary currency of the Minister is whether an activity will attract votes. There are very few votes in fair funding of General Practice. There’s a lot of votes in fair funding of patients fees. The sector has delivered this to the minister with nothing in return except extra work for most although VLCA got a large dose of new money.

I’ve heard a number of people justify this obsequience because “primary care asked for the policy”. I find it unfathomable that just because we argue for equitable funding of our patients GPs have to forego negotiating for fair and reasonable funding of the activities the state imposes on them. All the while working harder than ever because of the increased demand created by lower fees.

In the view of the majority of the negotiating team at PSAAP,including GPNZ and the contracted providers, because we have delivered to the minister in 2018 we will get want we want funded in this years budget. Their view of negotiation is that we are constrained by the budget and cannot argue for more than what is allocated.

This appears quite politically naive to me but then I’m only a GP.

It remains to be seen whether there is any opportunity to secure funding for all the costs that are crushing GPs that are beyond their control. We are unable to strike. Perhaps withholding agreement for policies designed to increase the chances of re-election will be the only way of ensuring we are fairly recompensed. Our representatives declined to take that position last year. Who knows how this year will turn out?

Ive given my youth, my family Christmases and (almost) my fertility to medicine. I will not be “nationalised” by Heather Simpson or David Clark - they simply cannot offer me enough carrots to be the Donkey with all the sticks. Cf NHS gp such an attractive profession that they are retiring young, emigrating here or exiting the profession. Good luck with that.

Dear  Minister .

 Can you  please tell  us what  the   costs are per  smoker who  quits  for each  of the  regional services  under  the   tobacco  control   realignment  for 2016-19?

In Whanganui   there were  153   who quit through the  regional Stop smoking Service Nga Taura Tuhono in   2016/17 for $ 340,000 ie  $2,222 per successful 4/weeks smoke free . In 2017/18 the number was 131 quits  or $2595 / successful  quit. 

 What are the comparative figures  for the  6 months  July  to  December  2018?

 What money   is  the Minister planning on  funding smoking cessation   services from  2019-  2020,21,22??? Smoking  cessation  support  under ABC  takes about 30 to  90  minutes  total per  person  who  quits .

Can  General  practice  be  paid the  same level  of  funding  please .?

Can  we get the  same level  of  funding  for    counselling for  our patients  please ?  for  dietary  advice  please ? for   cutting out  skin cancers please ?  for    doing home visits please? for  writing letters please? $2,500 would buy 25 hours of  counselling   or  5 patients  5 hrs each  at $90/ hr .

 If you  want  to keep  dying patients at home and out of ICU for the last  4 or 5 days of life  then  you need to pay for GPs  to have time for and do home visits  eg when a person with a stroke  is found unconscious . You need to fund a paliative care nurse to go in  at short notice to support the family overnight . They don't need ICU  they are dying  they need paid palliative care .in the home !

 Oh and  a paid  6 weeks sabbatical for every GP  every 5 years  might be nice too please.



Why is the NZMA so anti GP assisting with suicide?