1 Jul 2020

Covid-19 tests: Free or paid and who gets one? GPs seek clarity

5:25 am on 1 July 2020

Some doctors are charging for Covid-19 tests despite health officials saying they should be free.

COVID-19 Nasal swab laboratory test in hospital lab

Photo: 123RF

And there's also confusion about who should be swabbed.

The Ministry of Health (MoH) changed the testing criteria last week saying the priority was patients with symptoms, who had also been in contact with people recently returned from overseas or with people who had the virus.

Jackie Clarke, founder of The Aunties charity, said she went to an after-hours clinic with a woman who had a nasty cough.

When she asked the doctor about whether she needed a Covid-19 test she was told that would cost extra.

"She said... 'unless you have been exposed to it or a vulnerable to it', they are now charging $150 for it," Clarke said.

Other patients with symptoms but not high risk, who were told to get a Covid-19 test by Healthline, said their GPs told them they would be charged for the doctor's appointment.

This week, Director-General of Health Dr Ashley Bloomfield said no one should be paying for a test, nor the consultation that went with it.

College of GPs medical director Bryan Betty had written to GPs to ensure that message was understood.

While there had been some confusion, it was now clear that if a doctor or Healthline recommended a test the government would pay for it, he said.

The only exception was where people with no symptoms needed a negative test as a requirement for entry to another country.

Dr Bryan Betty of Porirua Union and Community Health.

College of GPs medical director Bryan Betty. Photo: RNZ / Karen Brown

There had also been confusion about who qualified to get a test under the new rules.

GPs have had differing interpretations.

Some felt there was little leeway to test patients who were not a high risk since the new criteria came into effect, while others said they were still testing anyone with symptoms.

Betty said the government still wanted surveillance testing, and that meant also testing some people with symptoms who were not high risk.

It was up to doctors to decide which low-risk patients should be tested, he said.

Green Cross Health clinical director Miriam Lindsay said a clearer direction was needed.

"The confusion comes from the MoH stating they 'encouraged' testing for surveillance purposes for people with clinical symptoms consistent with Covid, but there is a choice not to test," she said.

"As welcome as that is due to the extreme demand practices are under, a clear surveillance testing strategy would support the decision making.

GPNZ chair Jeff Lowe agreed there was some confusion.

He had phoned Bloomfield at the weekend to clarify what GPs needed to do.

"Like any rule change, like in Super Rugby, it takes a bit of time to interpret and then everyone to play by the rule book. And then there's discretion - different referees are going to play it different ways - there's room for interpretation," he said.

Betty said under the new criteria, most low-risk people with a minor sniffle were probably safe to say home.

But if they were unsure, if they had contact with someone from overseas, or their symptoms were more serious, they should visit their doctor or seek advice on what to do, he said.

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