Latest health funding fails to address crisis for family doctor services and will increase inequity through the post-code health lottery

This morning’s announcement by the Minister of Health highlighting additional funding for primary and community health services should be welcomed by a health sector that is facing significant historic underfunding and a major workforce crisis.

However, the funding proposals are fundamentally flawed and will increase inequity for Māori and Pacific populations as well as exasperating Te Whatu Ora’s already divisive post-code lottery for health.

Dr Tim Malloy, chair of GenPro, the General Practice Owners Association says, “Across New Zealand there will be significant numbers of Māori and Pacific patients who, whether through personal choice or lack of choice, are enrolled with family doctor providers who do not meet the government’s arbitrary criteria for the allocation of the newly announced ‘equity adjuster funding’. That will create new and significant inequities at a patient and health provider level – which, ironically, is the exact issue that this initiative is meant to help address”.

The Minister’s announcement covered funding streams for an equity adjuster, workforce development and, extending primary and community care teams through the potential introduction of additional health professionals such as pharmacists, physiotherapists and kaiāwhina.

The eligibility criteria attached to the funding streams has been developed without engagement with GenPro and Dr Malloy says that is a factor in the number of fundamental flaws which will create a range of negative unintended consequences. “The geographic targeting of funding to extend the primary and community workforce will exacerbate this country’s already inequitable post-code lottery with regards patients’ access to health services. A major component of the government’s health reforms and creation of a single Te Whatu Ora health agency was to ensure consistency of services for patients regardless of where they live. This latest initiative does completely the opposite”.

In 2022, the findings of an independent expert review* commissioned by the government found that general practice services are significantly underfunded which, it said, is "a serious deficiency in a core part of New Zealand's health system".

Dr Malloy says “The government seems to be ignoring its own commissioned advice and distracting the public’s attention through multiple minor, highly bureaucratic and siloed funding streams which will once again completely fail to address the crisis facing patients trying to access essential front-line family doctor services across the country”.

In November 2022, GenPro released a report titled On The Brink**, which found general practices are stretched and under threat and needed urgent support in order to deliver essential family doctor services across New Zealand. The report included a nine-point plan of action which was presented to the government and Te Whatu Ora.