Stoush over after-hours GP fees discussion

The chairmen of the South’s two main health organisations are at loggerheads after the Southern District Health Board refused a request from WellSouth chairman Dr Doug Hill to shift a proposed public discussion about after-hours GP charges to be held in private.

The meeting, of the SDHB’s community and public health advisory committee, went ahead yesterday, the item discussed in public.

Dr Hill — a committee member — was absent, having requested his non-attendance and the reason why be minuted.

He emailed every medical centre and GP clinic in the WellSouth region at the weekend, outlining his displeasure at the SDHB’s decision.

He told clinicians the paper contained commercially sensitive information and could lead to a poorly informed debate in the media about access to and the cost of after-hours services.

‘‘My concern is that the paper does not adequately represent the issues associated with after-hours,’’ the email, a copy of which was sent to the Otago Daily Times, said.

‘‘Nor does it present an accurate picture of the contracting arrangements and workforce challenges.

‘‘I would welcome a robust review and debate around after-hours services, contracts, funding and more, but not initiated in a public forum, and not in the absence of more detailed and balanced information.’’

SDHB chairman Pete Hodgson said he failed to understand Dr Hill’s concerns, and said much of the pricing information in the paper would have been publicly available on GP websites.

‘‘They asked if it could be in public excluded and my view was that it certainly should not be ...

‘‘I don’t really know what he’s on about. It’s publicly available information and I don’t think there is anything inaccurate in it, although it may be incomplete.’’

Mr Hodgson said the committee had asked for the pricing information to be collated to get a district-wide perspective of the cost to go to a doctor after hours, and availability of services.

‘‘What his [Dr Hill’s] arguments might be I don’t know because he didn’t put them to us.’’

The paper said demand for overnight urgent care was not typically high, and the cost of a consultation was typically large.

That meant overnight services usually required a dedicated funding model to operate.

Fees ranged from $62 for an ACC-funded injury in Dunedin, to $245 for a half-hour after-hours consultation in Wanaka.

Several central Otago clinics charged $180 for a 30-minute after-hours consultation, but some clinics did not charge at all to see a child aged under 14.

The paper said there were inconsistencies with access to, and cost of, after-hours care in the South and workforce challenges made it difficult to provide.

‘‘It may only take a loss of one or two people from a roster to make an entire service unviable ... the reliance on GPs as the only workforce for after-hours primary care in the southern district has left many rural and remote NZ towns vulnerable.’’


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