Stewart Barbara: Questions for Oral Answer — Questions to Ministers 
Stewart Barbara: Questions for Oral Answer — Questions to Ministers 
[Volume:623;Page:18379] 
9.  
BARBARA STEWART (NZ First) 
 to the  
Minister of Health 
: Is she confident that extra targeted funding made available to primary health organisations for the purpose of reducing the cost of visiting general practitioners has in fact reduced these costs in all locations; if not why not? 
Hon ANNETTE KING (Minister of Health) 
: 
 On average there has been a signification reduction in fees for those populations in the age groups for which additional funding is provided through primary health organisations compared with the fees charged for people who do not get Government funding. For those aged 65 and over the average reduction in July 2004 was $23.40. That reduction represents a reasonable flow-through of the increased funding that the Government made available of around $26 per visit. 
Barbara Stewart 
: Is she aware that general practitioners in some areas are increasing their fees and effectively absorbing increased Government subsidies as profits for themselves thereby ensuring that access to affordable health-care for our senior citizens remains dependent on where they live; if so how does she plan to remedy the situation? 
Hon ANNETTE KING 
: Some general practitioners did take the opportunity to adjust their fees when they received additional funding after no change in their fees for many years and no additional Government funding. However the Government does expect a sizable amount of the taxpayer subsidy to be passed on to patients. Where there has been a change in fees that has not been negotiated a process has been put in place to address that. 
Steve Chadwick 
: What is the process for deciding the fees that general practitioners will charge and what mechanism is in place to review charges that are considered to be too high? 
Hon ANNETTE KING 
: The fees charged are agreed through contractual negotiations between a primary health organisation and the district health board with Ministry of Health oversight. Should a primary health organisation decide to increase fees outside the period of the contract a fees review committee can be established to see whether the increased charges are justified. I note that the Capital and Coast District Health Board and the Wairarapa District Health Board have established such committees. 
Dr Paul Hutchison 
: Can she provide any rational evidence why the Government plans to roll out hundreds of millions more of the scarce health dollars on patient subsidies for 18 to 64-year-olds when there is clear evidence that universal subsidies are associated with waste; and is she prepared to change her strategy as Treasury and many others have suggested? 
Hon ANNETTE KING 
: No we have no intention of changing our strategy. I suggest that the member spends more time speaking to the public than trying to invent a health policy. The public will tell him that they would like to see the cost of going to their general practitioner reduced because they believe that has been a barrier to access. In fact research shows that to be the case. 
Judy Turner 
: Does the Minister believe that there is any link between general practitioner shortages in some communities and fee increases in the same communities; if she does what does she plan to do about that and if she does not think there is a link what advice can she give to patients who do not have the choice of changing to an affordable general practitioner practice? 
Hon ANNETTE KING 
: A shortage of general practitioners in New Zealand has been a problem that we have faced for quite some time. The good news is that we have more doctors wanting to be part of the general practitioner training scheme than we have had before. However I do think it is true that one of the problems has been that the income of general practitioners is considered to be low in relation to that of other doctors and they have sought to adjust some of that income over the last few years. 
Barbara Stewart 
: Is that practice by some general practitioners not a predictable consequence of the creation of another layer of bureaucracy in the health system with resultant costs to general practitioners that they are now recouping by bumping up fees while taking the subsidy? 
Hon ANNETTE KING 
: No. Most general practitioners in New Zealand were already part of an organisation. Many of them were part of what were called independent practice associations and many of them became primary health organisations. So in terms of another level of bureaucracy I disagree. 
Dr Paul Hutchison 
: I seek leave to table a memorandum to Cabinet from the office of the Minister of Health where Treasury notes that tying additional funds to specified age bands within the working population may not have the greatest— 
Document not tabled.