The General Practice Owners Association (GenPro) has cautiously welcomed the Government’s proposed changes to general practice funding, including a review and reweighting of capitation payments, annual funding uplifts, and measures designed to help limit increases in patient fees.
However, GenPro remains concerned about aspects of the package and its impact on a significant minority of practices.
Approximately 1,000 general practices yesterday received details of the proposed changes, which were provisionally agreed this week through a forum of health sector stakeholders, including GenPro.
GenPro Chair Dr Angus Chambers said the package represented the most significant review of general practice funding in more than two decades and acknowledged the Government’s willingness to address longstanding flaws in the system.
General practices will now consider the proposed changes and vote on whether to ratify amendments to contracts with Primary Health Organisations funded by the Government.
“We congratulate Health Minister Simeon Brown for undertaking a comprehensive review of capitation funding and recognising that the current system needed updating,” Dr Chambers said.
“General practice has been advocating for a fairer funding model for many years. The Government has made a genuine effort to address some distortions that have developed over time and better target funding towards patients with greater health needs. That said, a couple of big distortions – Very Low Cost Access and the Equity Adjustor – which should have been addressed, have not been.”
Under the proposed arrangements, around 60 percent of practices would receive increased funding through capitation reweighting and annual funding uplifts. However, approximately two in five practices would experience a reduction in income under the new funding formula.
To address this, the Government has proposed transitional arrangements that would protect practices from immediate losses by guaranteeing their existing funding levels.
“We welcome the decision to grandparent funding for practices that would otherwise be negatively affected by the changes. This means most practices should be no worse off in the short term while they adjust to the new funding settings.”
Dr Chambers said the transitional arrangements would help soften the impact of the reforms but would not eliminate longer-term challenges for some practices.
GenPro also welcomed Health New Zealand’s decision to reform rural funding support but said additional investment remains necessary.
“There are significant healthcare challenges in rural communities, and we urge the Government to commit further funding to rural general practice over time.
“The additional rural funding is welcome, but it is modest relative to the scale of the challenges facing rural practices and the communities they serve.”
Dr Chambers said the package reflected an attempt to address multiple issues simultaneously, including updating capitation settings, supporting practices facing rising costs, improving equity, and helping keep patient fees under control.
“That complexity means a small but significant number of general practices will see little or no improvement in their financial position despite the overall increase in funding.
“That said, we support the direction of travel. The Government has listened to concerns from the sector and has made a serious effort to improve the funding model.
“This is not a perfect solution, and it will not satisfy everyone. However, it is a constructive step forward and an important recognition that primary care funding requires ongoing attention if general practice is to remain sustainable, accessible and able to meet growing patient demand.”