Parents in Whanganui are outraged the city's main urgent medical clinic has begun charging for treatment of children during the day.
Whanganui Accident and Medical clinic has introduced a $10 charge for treating under-13s for medical conditions between 8am and 5pm.
The clinic is connected to Whanganui Hospital and shares a reception with its emergency department. It operates between 8am and 9pm and, according to its website, caters specifically to people without their own GP: visitors or people new to Whanganui.
It is also a preferred ACC provider and acts as triage for the hospital's emergency department.
Mother-of-two Kyley Logan said it was not always possible to get an appointment with a GP at short notice, and parents were being billed for a service that should be free.
"I guess as a parent we're really reliant on having an after-hours or an overflow service because there's such a lack of GP time available and obviously if you've got a sick child, that's not tenable.
"To me that's the reason why the government has put in place the free healthcare for under-13s."
In 2014, the government allocated $90 million over three years to extend free medical care to children under-13 years of age, expanding on a policy that already existed for children under six.
Ms Logan said the clinic's actions appeared to fly in the face of that initiative. She said the clinic was popular with parents and the charge would hit some people very hard.
"Really, in this community that is going to be the difference between people taking their child and getting the medical care they need or not because we don't have the option of going to an ED where it would be free and you can't get into a GP."
However, Whanganui Regional Health Network chief executive Judith MacDonald said the clinic did not get the same level of funding as GPs for treating under 13s for medical conditions during normal working hours.
Ms MacDonald, who is also a director at the clinic, said the large number of children turning up at the clinic this winter had put it under financial pressure.
"Between the hours of 8am and 5pm we are not funded by anyone for free under-13s and so we had been taking that hit, so we felt it was reasonable to create the modest fee of $10."
Ms MacDonald said there were still free services available for those patients who needed them.
"We spoke with our GP members and asked if they would be able to create capacity for either walk-in or same-day appointments for under-13s given that they were receiving the government subsidy, and they all agreed that while it was busy they could accommodate that."
Ms MacDonald said the clinic still offered a free, after-hours medical service for under 13s. However, it did not want to compete with general practices, and recommended families register their children with a GP, she said.
She said many people were under the false impression they could choose to go to the clinic or the emergency department and that was not the case.
The co-location was working well, she said, and while patient traffic at the clinic had increased by 13 percent over past year ED volumes had only increased by 5 percent, indicating patients were being sent to the right service.
Whanganui Health and Disability advocate Bronwyn Hughes said the clinic's location at the hospital, and its multiple roles, were problematic.
"The community consensus is it that it causes confusion. The number of times that people have to clarify whether people went to ED or the Whanganui Accident and Medical clinic.
"The other question we often ask is did you get a bill. If you got a bill you went to the clinic."
Ms Hughes said people in Whanganui often needed reminding the clinic was a private business and had the right to charge - even for children.
"Every non-government agency that works with people who are vulnerable, we say to them unless it is an absolute emergency go after 9pm."