Medical Association welcomes DHB funding, but wants recognition for GPs

The New Zealand Medical Association is welcoming a $3.92 billion investment in District Health Boards (DHBs) and money for hospitals to catch up on procedures delayed by the lockdown, but questions where recognition is for general practices (GPs).

On Tuesday, the Government announced $3.92 billion would be pumped into DHBs to ensure New Zealand has a world-class health system. A one-off boost of $282.5 million has also been put aside over three years for hospitals to catch up on procedures delayed by the lockdown.

"As a Government, we’ve put a significant amount into DHBs to put them back on the path to sustainability. This is a long-term plan, as rebuilding our health system will take sustained investment over a number of years," Health Minister Dr David Clark said.

"We don’t want people having to wait for care any longer than necessary. This extra investment in planned care will fund an estimated 153,000 surgeries and procedures, radiology scans, and specialist appointments over the next three years."

Dr Kate Baddock, chair of the New Zealand Medical Association, has welcomed the pre-Budget announcement, saying funding to increase capacity for elective surgery and other hospital services is "great news" for those who have had treatment postponed.

But she said in a statement that the announcement was "silent on health services that are delivered outside of hospitals and in our communities".

"It's fantastic that the Government has recognised the chronic underfunding of hospitals and DHBs and made a very significant investment in the workforce and the capital costs required to maintain the actual hospital structures themselves. I think that is great," she told Newshub.

"What I find extremely disappointing is the invisibility of primary care in that announcement."

Dr Baddock said general practitioners were vital in combating COVID-19 while also caring for Kiwis with other health issues in the community.

"The general practice and primary care have shown how they can respond to issues which arise, such as the COVID-19 pandemic, which did not overwhelm our hospital system and that can be credited almost entirely to the way in which it was managed in the primary care setting," she said.

"For that not to be recognised in terms of the need for further investment in the post-COVID world that we will be operating in is an extreme disappointment."

After being "chronically underfunded for the last decade", GPs had been pushed to the "brink of falling over" during the lockdown, Dr Baddock said. While many GPs set up virtual consultations during the lockdown, Dr Baddock has previously said Kiwis didn't want to burden doctors or "didn't perceive their concerns as being important in the greater scheme".

"General practice, if it doesn't get an injection of investment funding, is not going to be able to have the capacity nor the capability to be able to expand what it already does to allow more care to take place in the community setting and outside hospital."

Prime Minister Jacinda Ardern acknowledged in April the pressure on GPs and the costs they faced during the lockdown, and said funding had been provided.

"What I'd point out for the likes of pharmacies, the likes of GPs, support has been provided to them. In fact, $45 million to date has gone into general practice to support them during the COVID response," she said at the time. 

"That's for everything from supporting the virtual consults that they’ve been doing, for additional cost as a part of testing, and also they have been eligible for the wage subsidy."

However, the Medical Association has said GPs didn't receive a second tranche of funding they were expecting in April. Director-General of Health Dr Ashley Bloomfield said at the time: "There is an active conversation between the Minister and general practice leaders and the ministry on further funding… I don’t think it’s been taken away, but the conversation is ongoing and active".