GP visit funding boost welcomed, other rural health inequities remain

The announcement that an additional 600,000 low income New Zealanders will have the cost of their GP visit capped at $18 is welcome news, however other longstanding health inequities that affect rural people still need to be addressed, says New Zealand Rural General Practice Network Chief Executive Dalton Kelly.

“We are encouraged to see that the government is acting to ensure that low income New Zealanders, which includes those in rural communities, get affordable access to GPs, however there are other issues that have been festering away for years in rural health care that have not been addressed.

“Service provision differs hugely between rural and urban, as do facilities, and third party funding is the reason some areas have new facilities. We know of many examples where practices have to go to their communities just to have access to more expensive equipment they need, such as ECG machines.

“There are also longstanding issues around workforce and training and the need to address difficulties recruiting and retaining health professionals in many rural communities,” says Mr Kelly.      

Cheaper GP access for more low income New Zealanders could also mean onerous compliance issues and this will put significant pressure on general practice and more so in rural, which does not have the advantage of bigger organisational support. The Devil will be in the detail,” says Mr Kelly.

The Very Low Cost Access scheme (VLCA) should still be reviewed, he adds.

“The extra funding has achieved what the VLCA couldn’t and that’s hugely beneficial for low income patients. The flip side is that there are those who are receiving the subsidy who don’t need it. It still comes down to the funding following the patient and not the practice,” says Mr Kelly.

The need to change the VLCA scheme and address other issues of access and equity in rural health was highlighted in the Primary Care Working Group’s 2015 report on General Practice Sustainability, led by Wellington GP Peter Moody.

“Up until now, not much has been done to address many of the issues highlighted in the report,” says Mr Kelly. The other high priority issues for the Network are rural health education/workforce and water quality.