Budget 2020: GPs still waiting for their healthcare revolution

14 May 2020

The Royal New Zealand College of General Practitioners is disappointed that general practice has been left out of today’s Budget announcement and say GPs need to be included in what the Finance Minister described as, “further support to the health sector in the coming months.”

The College had hoped to see health and technology measures funded that would help general practice respond and rebuild after the sector has been on the very frontline of New Zealand’s COVID-19 response.

The College had hoped to see technology funded so that GPs across New Zealand could be better supported to provide and build on remote consultations. During the Covid-19 response GPs acted quickly and nimbly, pivoting their business model to allow for most of their consultations to happen remotely. An unexpected outcome of that was to give greater medical access to high-needs and rural communities who no longer needed to travel great distances or spend unbudgeted money for the likes of petrol to get the care they needed.

College President, Dr Samantha Murton says, “Our focus for some time has been on health equity because there is clear evidence that some New Zealanders are not getting the healthcare they need.” 

“Ethnicity, location, cost of care, and rurality are all barriers to primary healthcare access in New Zealand, which this Budget needed to address urgently so that those falling behind don’t continue to suffer in the aftermath of Covid-19.

“Some of the measures announced today will benefit our patients and therefore boost the health of New Zealand but the Government needs to keep talking to us, so our sector is also supported to deliver on critical public services.”

Investment into general practice would ensure patients continue to be supported through the strong relationships, whakawhaunaungatanga, that they have with their GPs and not rely on quick-fix ineffective solutions like health apps that fall down on the relationship and medical history criteria.

Support is also needed to ensure digital health technology is equitable, especially for Māori and rural patients, and effective and accessible for those with higher needs based on language, disability, or age. 
 
Funding rethink

The College acknowledges the $3.92 billion in operational funding for health over the next four years. However, while some will trickle down to GPs who provide planned care after operations, it’s not likely to provide support to the struggling sector that was on the frontline of the COVID-19 defence.

The Budget also hasn’t acknowledged that GPs will also be dealing with a huge number of patients with deferred care and will require support to cope with the demand. 

“Now is a prime opportunity to rebuild our health system and that starts where people go most – to their general practitioner, says Dr Murton.

“It is critical that we are involved when Government works towards further support for the health sector in the coming months.” 

The College says that the way primary healthcare is funded in New Zealand needs to be reworked to cater to an increase in remote consultations, which have sometimes proven difficult to charge for. The capitation model, which is very ‘one size fits all’ needs to be reworked to better cater to patients that are increasingly complex because they are older, living in deprivation, have co-morbidities, or a mixture of all these.

“I haven’t seen anything in today’s Budget that shows me a revitalised future for general practice in New Zealand but I hope that in the next few months we can get there.

“I am hopeful that the Health & Disability System Review, which we are still waiting to see, will delivery the ambitious goals I was hoping to see today, says Dr Murton.

Being an election year, the College is seeking cross-party political agreement for funding the future of general practice and to support improved health outcomes for all New Zealanders.