One in five general practices lost money last year. Photo: RNZ
One in five general practices lost money last year, and more than half are struggling to recruit enough doctors.
That is according to a survey by the General Practice Owners Association (GenPro), which found however the overall prognosis for primary care is less dire than it was.
Key findings of the GenPro Annual Pulse Survey include:
- One out of five general practices made a loss last year
- One in four say their financial position has worsened - a big improvement on two years ago, when it was four out of five
- Two out of three practices are charging patients for what used to be free, similar to previous years
- Four out of five general practices are taking new patients, a slight improvement.
GenPro chair Dr Angus Chambers said the results suggested general practices were feeling "slightly more optimistic" after some horrendous years when many closed down, merged or reduced services to patients.
"While the results are more positive than in previous years, we expected to see an improvement from what had been a desperate situation.
"General practice is out of intensive care but is still in the recovery room."
GenPro chair Dr Angus Chambers. Photo: Supplied
To have nearly a fifth of practices losing money was "not sustainable" - and meant there was a risk of some communities losing doctors, unless more was done to improve their financial viability, he said.
"If 18 percent of our practices had to close, that would make a very significant difference.
"We appreciate that government has increased its support of primary healthcare and is overhauling the current out-of-date funding model, but neither step has increased the supply of medical professionals into primary healthcare, meaning family doctors remain overworked and too many patients still cannot easily access a GP."
Under changes rolling out from July next year, capitation funding (the government funding that practices receive for each enrolled patient) will reflect patient complexity, socio-economic deprivation and whether they live in rural areas, as well as age and sex.
"There are some flaws in the new calculation, some think it should include ethnicity, but overall it will be a big improvement - as long as the total funding also increases, and it's not just a redistribution of the current funding, because that would mean some lose funding.
"If you're in that 18 percent that are making a loss and your funding goes down more, then you'll be in a trouble."
The situation for patients was still "sub-optimal" with more than half of practices with doctor vacancies and nearly one in four still looking for nurses.
Some 85 percent of respondents had recently increased, or were about to increase, their fees.
"One bright spot is that only 29 percent of general practices had reduced their services, a sharp reduction from 54 percent two years ago.
"This shows the situation for general practice is stabilising, and it would improve even further if we could do better at recruiting medical professionals," Chambers said.
While the results were encouraging, much more improvement was needed.
The survey, carried out in August, had 226 respondents, representing about a quarter of all general practices in New Zealand.
Health Minister responds
Health Minister Simeon Brown. Photo: RNZ / REECE BAKER
Health Minister Simeon Brown said the additional $175 million for general practices this year represented a 13.89 percent increase after many years of underfunding.
"Not only is this the largest boost ever provided, but it's more than double the highest annual increase since capitation was introduced.
"This directly responds to what the sector has been telling us for years - that the funding model must be more sustainable, more responsive, and better aligned with outcomes that matter for patients."
The changes to the funding model would also ensure funding went "where it's needed most", to support communities with the highest health needs.
"We are committed to the continued strengthening of primary care to ensure that all New Zealanders have access to the timely, quality care they need, when they need it."
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