Episode Transcript
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Speaker 1 (00:05):
You're listening to the Weekend Collective podcast from News talks 'b.
Speaker 2 (00:10):
Yes, Welcome back to the Weekend Clicktive. This is Politics
Central and proposed changes between Health New Zealand and the
Primary health primary care sector show that the cost of
GP visits won't be increasing for about twelve months. The
cost for a doctor's visit will be thrown frozen until
July next year, with both sides recognizing the importance of
maintaining affordable healthcare at a time of high living expenses.
(00:33):
I think I should say reportedly, as part of the agreement,
Health New Zealand is boosting primary care by about one
hundred and twenty million to cover the inflation in funding
GPS and to cover the frozen visit fees.
Speaker 3 (00:43):
So is it really a visit.
Speaker 2 (00:47):
A visit freeze if it's coming out of our pockets
I guess and the taxpayer well individuals.
Speaker 3 (00:52):
Yes.
Speaker 2 (00:52):
But here to unpack the proposals and the overhaul of
the GP funding model, it's Health Minister Simeon Brown.
Speaker 4 (00:58):
Good afternoon, Good afternoon, How are you not too bad?
Speaker 2 (01:01):
I'm not sure how I summarize that, but the principal
agreement between Health and New Zealand and the primary care sector,
how's that going to work and at what's needed to
get it going in practice.
Speaker 4 (01:14):
So every year Health New Zealand negotiates with primary Care
on the funding uplift and the priorities within that uplift
on an annual basis, so that negotiation normally starts a
few months before the financial year begins in the first
of July, and it looks at a number of areas
around how we can support increased access for patients, looks
(01:37):
at what the investment into primary care is and where
that funding goes, and so there's a number of things
that are being considered as part of this in principal agreement.
One is an uplift for funding to primary care, which
is really important to make sure that primary care is
well supported to see patients and remunerate the workforce who
(01:58):
deliver an excellent job on behalf of New Zealanders. Secondly,
it's looking at fees and making sure that there's ability
to ensure people affordability whilst also noting that subsidies exist
for people on community services cards and people in very
low cost access areas as well. But also it's rewaiting
(02:20):
the funding formula quite significantly this year, which is something
that hasn't been done for over twenty years, and actually
making sure that the funding recognizes the needs of the
patients on their GP's books. And that's really important to
make sure GPS are actually funded appropriately for the type
of patients they've got. For example, rural gps haven't been
(02:41):
having the fact that their own rural communities appropriately representing
the formula. So a lot going on in this agreement.
It's now out for consultation with GPS and we'll see
how that goes.
Speaker 2 (02:52):
Does that mean that some of the money is going
to keep those fees the same, but also some of
the money is going to acknowledge the funding shortages and
struggles that GPS have just in maintaining what they've got now.
Speaker 4 (03:05):
Yeah, So the funding is going into a number of
key priority areas. One is an uplift to deal with
cost pressures and that's that's that's really important to make
sure we are funding our GPS properly. Secondly, it's looking
at the fees, how do we keep fees affordable. Thirdly,
it's rewaiting the fees around need and so if patient,
(03:26):
if a GP practice has is in a rural community
or has a number of patients who are high either
high deprivation or a lot of comorbidity, so multiple illnesses.
They will be receiving more funding than a GP practice
would which has more and more urbanized practice. And so
we're actually rewaiting the formula based on the patient's needs
(03:48):
on the book, and there's additional funding going into support
grandfathering that new formula in as well. And there's also
funding going into support and incentivized GPS which are around performance,
key performance metrics such as immunizations, screening programs and other
things as well like that. So there's the one hundred
(04:10):
and twenty million dollars in the draft agreement goes into
a number of key things, and it's all about how
do we increase access to primary care and support primary
care to do more in the community.
Speaker 3 (04:19):
Actually, the incentivizing thing is that.
Speaker 2 (04:25):
Is that going to be something in which GPS will
actually be able to make a real difference with in
terms of incentivizing them to get vaccination rates up and
cold flu all that sort of stuff.
Speaker 4 (04:36):
Yeah, so one of the areas will be around child,
around child of immunization. So the government has a health
target of ensuring ninety five percent of two year olds
are fully immunized, and we have we're putting some of
the money we'll be going into an appalled for incentivizing
GP practices which make progress towards that that that target. Obviously,
(04:58):
GP practices are the sort of on the on the
front line for that health target, and we want to
make sure that those practices which are doing well in
getting good progress against the target were well supported and
are incentivised in order to do that.
Speaker 2 (05:14):
Actually, does I guess at the cold face, does that
simply mean that there'll be it will incent incentivized gps
to have more thorough and consistent messaging to their patient base.
Is that how you would imagine that would play out,
so they'd be rely, Yeah.
Speaker 4 (05:30):
We want them to prioritize this as a key health
target for the government. When you think about the measles
outbreak we had last year. You know, we've had a
significant reduction in immunization rates in the last since since
since COVID it started coming back, since we put the
health target back in place under this government, and so
we're starting to see some progress against that target, but
(05:52):
we want to continue that progress. I guess GP practices
will know their patient's best, they'll know how best to
have those conversations.
Speaker 2 (05:59):
I guess if I could just jump if I could
just jump in, I guess I know that. But I
would have thought that these are health professionals, not that
they need incentivizing, But what else could they possibly do,
because surely that must be at the top of their
list for their especially the most needs sort of demographic.
Speaker 4 (06:18):
Well, I think absolutely it is a top priority for
all GP clinics, But at the end of the day,
they've also got multiple priorities that they're having to manage.
This seems a very clear message from the government that
this is a top priority for the government and we
want to incentivize them to make sure that they're making
good progress with their patients, to increase those immunization rates,
and to protect public health.
Speaker 2 (06:40):
Is there a chance that there, I mean, one of
the ways of reducing healthcare costs might not actually be
literally to lower the cost of GP visits, but to
extend a freeze for longer and longer. Is there any
chance that that might be on the horizon as a
government policy beyond the twelvemonth temporary freeze.
Speaker 4 (06:56):
Well, I think at this stage. We've got a proposal
out for consultations in Health New Zealand in the primary
care sector. I think from our perspective, it's very much
around how do you make sure that we improve access,
maintain affordability and then target support to those who need
it the most. And that's why we have lower fees
for people on community services card. I think they pay
(07:18):
around twenty dollars to see a GP. If you live
in an area with a very low cost access practice,
it's around thirty thirty one dollars through two dollars to
see a GP. And so those are the targeted initiatives
we've got in place. We also have free GP visits
for children under the age of fourteen, again an initiative
to make sure that we're targeting towards those needed the most.
(07:41):
That's a very much the way that we as a
government focus on this. People like myself, you know, who
earn significant salary as a Minister of the Crown or
the leader of the Opposition Crssipkins, we don't need you know,
it's not our view that we should be subsidizing and
making GP visits free for people who earn larger salaries.
Speaker 2 (08:03):
What about what about I don't want to put it
this way, but I'll just you'll know what I mean.
What about cheeky GP practices. You might hear hear about
this and think, oh, I better bug the fees up
right now.
Speaker 4 (08:13):
So the way it works is that they set their
fees on an annual basis. Yeah, And so that's the
approach that it works through this negotiation process and so
the moment that's out for consultation, but they can only
set their fees on an annual basis, and most GP
clinics would have done that at the beginning of this
financial year.
Speaker 2 (08:31):
And it's not I mean, the freeze isn't done by Hey,
here's a heel of your legislative freeze. This is a
freeze in agreement based on the government doing its bit
and primary practice doing its bit.
Speaker 4 (08:42):
That's right. So it's a negotiation. Ultimately, the government will
be putting additional funding towards primary care to support primary
care in order to not increase its fees for this
coming financial year and so effectively to cover that additional
revenue that they would have otherwise got. But as I said,
the number one, key, number one thing for New Zealanders
(09:04):
right now is making sure they can excess and appointment.
We want to make sure gps are well supported to
be able to do that.
Speaker 2 (09:12):
Okay, just a couple more questions. So a Shaverra, obviously
in opposition, says that this locks in high fees rather
than bringing them down.
Speaker 3 (09:19):
What it's your response to.
Speaker 4 (09:20):
That, Well, the Labor Party's approaches for people like me
and Chris Hipkins, who earn over three hundred thousand dollars
a year should get free GP visits. That's ridiculous. It's
completely untargeted and doesn't actually doesn't actually deal with the
real issue, which is how do we make sure people
can actually get an appointment. The yestiny to make sure
(09:44):
that fees are affordable, and that's why we subsidize people
in community services cards. That's what's free with people under
the age of fourteen. That's why we've got the very
low cost access scheme. It's about targeting money towards those
who need it the most, rather than subsidizing people like
me and Chris Hipkins earn seven hundred thousand dollars a year.
I can tell you what that all that policy w
(10:05):
do is increase pressure on GP clinics, make it harder
for people to get appointments when they need one, and
so far I've seen nothing from the Labor Party on
how they can actually make it easier to see a GP.
Speaker 2 (10:15):
I think Chris Hipkins Ears will be buzzing right now
that you've name checked them a few times. Actually, just
one quick thing, one of the big things for families.
I know that you mentioned the free healthcare until fourteen,
but then obviously there's still kids who are religant on
their parents. Is there any chance you'll be looking to
extend the age for that while kids are still at school.
Speaker 4 (10:35):
Well, let's not get part of this proposal. It's currently
out for consultation at the moment. This is looking at
the current policy settings. How do we make sure that
we can maintain and improve access and maintaining and maintain
fees is where they currently sit. So that's the approach.
This is out for consultation at the moment with GP
clinics and we'll see how that goes.
Speaker 3 (10:56):
Hey, what do you think? I mean?
Speaker 2 (10:57):
This is probably a difficult question to answer because I
know it's a multifaceted job you've got as health minister.
What do you we see is essentially the biggest challenge
for the health sector right now because is it all
just more money, money money, or are there things that
we can do in terms of efficiencies And what's the
biggest priority. I guess I've mixed that question into about
(11:18):
three questions. Sorry, but anyway, what's the biggest priority I'd
love to nail right now?
Speaker 4 (11:24):
Well, the number one thing for me is improving access
for patients. You know, we inherited a health system which
was under real strain, weightlisted balloon and weight times had
grown significantly. So reducing wait times for patients is my
number one priority, whether that's an emergency department, whether that's
for an elective surgery, or whether that's to see a GP.
And so that's where our priority very much is focused.
(11:47):
That's why we've put the health targets back in place.
At the same time, though, we've invested sixteen point sixty
eight billion dollars additional funding over three budgets, which is critical.
We're growing our workforce. We've got over six hundred more
doctors working at Health New Zealand today, around two hundred
two thousand more nurses working at Health He's on today.
And when we came to government, the workforce in the
(12:08):
funding really really matter. But we also need to make
sure the system is delivering and we need to drive
efficiency so people can get more timely access to those appointments,
to those surgeries. And that's where my focus is, Minister
of Health, very much since.
Speaker 3 (12:21):
Hey, Simeon, I really appreciate your time this afternoon. Thanks
so much, thank you. There we go.
Speaker 2 (12:27):
That's the Health Minister, Simeon Brown. Actually I thought that
was a pretty good answer to that question. Actually, the
because you know, all of us, if you want access
to the health system, it's all about waiting times and
getting in there, isn't it. But I like the reference
to Chris Sipkins. I think three times he name checked him. There,
didn't he chrisip Cans will be sitting somewhere having a
coffee in the after and going, oh, he is feeling
(12:49):
hot for some reason. That's something that Simian prepared earlier. Possibly,
But you know, it is politics, isn't it. That's the
name of the game.
Speaker 3 (12:55):
Hey, look, actually look, I guess.
Speaker 2 (12:58):
The broader question is, you know, did you agree with
his response to what the greatest priority should be for health?
But actually I was just earlier on when he mentioned
that one of the bits of the policy was about
incentivizing gps to get certain rates up, including immunization, and
as we know, we've got measles immunization rates which are poor.
(13:21):
I think that is a great idea what I think incentivized.
And I know, of course gps are incentivized because you know,
you're not in health because you're there necessary for the money.
You're there because you care about people. You care about
medicine and making people well or preventing them from getting sick.
So I mean, obviously they are already incentivized, but perhaps
by giving a financial incentive to up those rates, then
(13:43):
it just energizes each primary care practice to really be
focused on those goals.
Speaker 3 (13:48):
So I actually think bingoing on that.
Speaker 2 (13:51):
You know, I know I should be cynical and go
oh boo bar humbug to something, but that's the thing
that got my.
Speaker 3 (13:56):
Attention the most. What about you?
Speaker 2 (13:58):
It's eighteen minutes to four News Talk zed B.
Speaker 1 (14:01):
For more from the weekend collective, listen live to News
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