Visiting the doctor - too high a cost for some?
How much should a visit to your local GP cost?
Too much for some, apparently. Even the most cursory net survey of medical and health centres around the country reveals Golden Bay folk are currently being charged near the higher end of what you’d expect a registered patient to pay anywhere. It now costs an adult (over 18) a flat $40 fee to see a GP in Golden Bay (with under 6 free and 6-18 years $21), with no discounts for a Community Services Card, which under current regulations can only be used for gaining flat fee prescription charges anyway.
Some folk, like Pauline Nichols of Waitapu, are now opting to travel to Motueka for their appointments, where they combine their shopping with seeing a doctor for just $16 at Central Medical Motueka.
“What my husband and I save overall on medical costs and picking up a few basics easily outweighs our fuel costs. We don’t think locals going shopping over the Hill for anything is a good thing, but that’s the position we have been put in by these high medical charges. Even a routine blood test is free in Motueka, and it’s not here.”
Although blood tests as part of a consultation are often included in the fee at the Golden Bay Medical Centre, a patient-requested lab test is charged out at $40.
Nelson Bays Primary Health Organisation (PHO) took responsibility for the running of the medical centre on 1 April. Last week, its manager, Andrew Swanson-Dobbs, admitted that the charges were comparatively high, but said the issue was complicated.
“There are three ‘low cost access’ health providers in the Nelson region that negotiated extra funding from the previous Labour Government in return for keeping consultation charges around $15. But those criteria changed abruptly under National, who now only offer them to communities with high numbers of Maori or Pacific Islanders, or which have low decile incomes. This means Golden Bay does not really qualify any more, if it ever did.
“But there are other funding possibilities that we could look at that may see the cost of seeing a doctor in Golden Bay come down.”
So why didn’t the four doctors who ran our medical centre prior to the PHO takeover pursue “low cost access” in return for more funding when they had the chance? Dr Struan Clark believes no such opportunity really presented itself at the time.
“From what we understood, Golden Bay simply wasn’t eligible because the qualifying criteria were based on socioeconomic ones, and we didn’t fit. We didn’t really have access to all the figures, anyway. The deal had to stack up and it certainly didn’t jump out at us.”
Dr Clark is keen to point out that although an over-the-Hill appointment could seem cheaper, patients have to be registered (solely) with that health provider, so if you suddenly need after-hours or urgent treatment here, then the cost as an unregistered patient could be high.
Another cost under fire recently, this time nationally, is prescription charges. Research in the latest international Journal of Epidemiology and Community Health found that six per cent of the 18,000 New Zealanders surveyed put off filing a prescription for financial reasons at least once a year. That figure jumps to around 15 per cent for Pacific and Maori people. Lead researcher Santosh Jatrana was reported as saying in The Dominion last week that it was particularly worrying that more and more people who had two or more illnesses—and who needed multiple prescriptions—were simply avoiding picking up their prescriptions.
“People who put off buying prescription drugs because of cost are far more likely to be admitted to hospital with serious acute conditions. It could well be that the total number of people not filing prescriptions or even putting off a visit to the doctor could be higher than the study suggests.”
The current charge for prescription drugs subsidised by the government is a flat $3 fee. People who need 20 or more prescriptions in a year are eligible for a further subsidy, but have to spend $60 before they become eligible.
Back when it was under local ownership, the Golden Bay Medical Centre boasted an active Community Health Group made up of interested locals whose job was to actively tweak ways of improving customer service, including consultation charges. But this group went into recess around five years ago, some speculate as interest in integrated management began to get off the ground.
Andrew Swanson-Dobbs admits the PHO is feeling its way into the Golden Bay medical scene. “Taking over the medical centre over there has been a steep learning curve. Sure, there’s a few management things to sort out, that’s to be expected; but in the end I am confident of a good outcome for everyone concerned.”
Gerard Hindmarsh
