Note: this is a preliminary investigation based on a talk with my local GP clinic and lots of googling. There may be inaccuracies which you are free to point out. We will find out more when we get the chance to talk to Procare and other PHOs. I think it is an important issue. 

Important info

  • Primary health is at the community GP level as opposed to tertiary health care in the hospitals. 
  • Primary health organisations (PHOs) are funded by district health boards (DHBs) to ensure the provision of essential primary health care services, mostly through general practices, to those people who are enrolled with the PHO.

A number of our members can't work, have multiple side effects and need regular medical care. In some parts of the country, a GP visit costs $60, in other areas $17.00. The higher charge is a burden for cancer patients.

Why is there this discrepancy? It's because some parts of the country are deemed to be areas of deprivation and receive more funding from the government via the DHBs. A patient who is enrolled with a GP is entitled to a subsidy but this is much smaller if the patient lives in a relatively affluent area. Auckland north of the harbour bridge is an area of privilege apparently while some parts of central, west and south Auckland have large subsidies.

Provincial towns like Whangarei and Rotorua receive substantial subsidies too with GP visits costing only $20 at the most. Even the healthy and well-off benefit from this system, while a cancer patient with a community services card in Albany, say, will have to pay $60. Yes, even those with a community services card have to pay the full fee at most clinics. 

(Since starting this story, I have discovered that there is something called the Very Low Cost Access Scheme. This  gives clinics in which 50% of their patients are high needs a substantial subsidy. The well off who attend those clinics benefit too while the same patient with the same income and health issues pays three times as much in a different area. Health Minister Jonathan Coleman acknowledges the problem but has put it in the too-hard basket. See the Stuff article below.)

There is some funding for people with severe chronic illness and for terminal patients. A cancer survivor with health issues does not seem to qualify. Some clinics will offer a small number of visits a year at a higher subsidy. A patient on a benefit might qualify for Care Plus, a status the clinic is funded for. Patients need to clear this up with their clinic. It doesn't seem to be offered and has to be asked for. 

To receive any subsidy at all, patients have to be enrolled at a clinic that belongs to a Primary Heath Organisation. These organisations manage large clusters of GP practices throughout the country. Nearly all GP clinics belong.  Most Auckland GP clinics for example, come under the umbrella of Procare.

Other PHOs are : Alliance Health PlusTrust (Auckland), Manaia Health PHO Ltd (Whangarei). However, in spite of the subsidies given clinics by the PHOs, they are not enough to make GP visits affordable for those of us who live in "affluent" areas without comprehensive health insurance. 

WINZ offers help to beneficiaries to help pay medical costs but it looks like a service that needs to be rigorously applied for. At the time of writing, WINZ was well nigh impossible to reach because of the earthquakes. We'll supply more information at a later date. 

 You can find a list of GPs and their fees on the website of your local DHB or PHO.

Below are links to two Stuff articles, one from Nelson and one from Auckland. If the links don't work, you can copy the URL or search for the stories.

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Diana Ayling

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