National's flagship telehealth costs Kiwis up to $99 a call as Simeon Brown funds telehealth providers 3-4 times higher than GPs
As primary healthcare stutters around the country, why is National trying to kill it off?
Leaked documents from Te Whatu Ora showed National planned to pay telehealth providers - including ‘reluctant PHO' Tend Health - between 367% and 433% what it funds struggling GPs for casual patients.
The telehealth service is targeted at those not enrolled with a local GP.
But as GenPro Chairman Dr Angus Chambers pointed out, the funding plans showed telehealth providers would be funded between $55 and $65 for each consultation.
GPs received around $15 for a casual adult appointment and $30 for a child.
I reported earlier in the year that Christopher Luxon was boasting to Mike Hosking about how telehealth will revolutionise healthcare.
It never has - it’s a supplement, not a replacement.
As Dr Chambers points out, all these moves will do are the following:
Undercut and undermine family practices around the country, leading to the loss of experienced and community based GPs
Family practice is already failing to attract new doctors and this trend will make it much worse
We will lose frontline GPs who will move home to write scripts and deal with minor issues instead.
GPs in the community have significant overheads - telehealth has very little. This undermines GPs and comes after the government broke their election promise to properly fund GPs.
Cause more GPs to sell up to private equity firms, and/or leave the country
Fails to address the real reasons for long wait times and waiting rooms i.e. complex medical cases, which telehealth does not address
Does not account for preventative healthcare - which is key to well being and longevity
After the leaked documents were revealed, Simeon Brown denied this was the case, saying it was just “speculation” and the time to talk about it was not before the service was launched.
That was last week.
Today, Simeon Brown unveiled the launch of the telehealth program.
He calls it a 24/7 GP service, and in reviewing the costs from providers, most will cost $80 - $99.1
Why wouldn’t this government care more for the GPs though?
The ones that hold up our communities, care for their patients, get to know each person, suggest and help with preventative care?
And is it any surprise Tend is on that list? There are still so many unanswered questions there.
I’ll leave with remarks from the GP of a long standing practice on these developments:
This is dreadful. Massive funding favouritism for telewealth providers. We’re losing good young GPs from coal face General Practice and why wouldn’t they. 3 x easy patients an hour taking 5-10 minutes each, no paperwork, referrals, labs to chase, phone call follow up after hours and you earn far, far more. There are no overheads in Telehealth. Just think of the overheads in General Practice. We look after xx,000 patients, employ xx staff including xx GPs providing some of the best care in NZ to the highest needs, gross $ x million a year and have not made a profit for over 5 years.
And
This isn’t medical care. This is a phone call, no examination and invariably with a less than average doctor who is not capable of real medicine or an ill equipped nurse.
As for the increasing push for Physician’s Assistants and Nurse Practitioners to assume doctor roles, anyone who thinks this is ok needs to read Patients At Risk, a brilliant evidence based summary of why it is such a dangerously bad idea.
This is the path we’re heading down.
This is our government and I can’t think of any reason why it could be so callous. Or why so many Kiwis still support them.
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$84 is the average for those with defined fees - no community services card
Privatization by stealth. Where are the MSM on this?
My solution is to fund GPs properly instead of as the government told them during the last funding round to pass the shortfall onto patients.
Give the GPs and other staff working in practices a substantial pay rise to make it attractive to work in this service again.
Gradually employ GPs and their staff like in secondary and tertiary care ie by the government.
Ensure all appointments are free for everyone (including dental).
This would have the flow on effect of stopping so called inappropriate ED attendance (who would pay $50+ when you can get free care in ED, if this money is required for food or a utilities bill), also having more GPs ensures continuity or care, as you would see the same doctor more often than not.
How do we do this? Progressive tax, ensuring the wealthy pay their way as part of a fairer society that cares for its people. Instead of the corrupt uncaring mess we have now.
Funny, I read this today while sitting in Masterton Hospital ED.
My partner is unwell, and we went to the local medical centre on Sunday. Things got worse, so ED today.
The staff were absolutely amazing. He had a renal transplant 20 years ago, and has had several abdominal pain, so was deemed high risk.
The nurse was honest and apologetic. They had nine patients in ED waiting for hospital beds. And more in reception waiting to be triaged.
I could hear the Westpac chopper taking patients to Wellington for more serious issues.
Overhearing some comments, clearly some were there that could have been seen by a GP. SEEN…
I don’t blame them for being at ED. GP appointments are hard to get. Telehealth will not help when a physical exam is necessary.
It’s not right. GP’s and health staff must be assisted by the Government.
I watched the nurses and doctors rushed off their feet, and wished Simeon Brown, Luxon, Seymour, Willis, and Bishop spent several hours in ED to see reality.
Who would want to because a doctor or nurse to end up working in this environment??
I pay tribute to the hard working staff of our too-small Wairarapa hospital.
They do an amazing job no matter the volumes of patients, pressure and stress. We cannot lose these workers. They are invaluable, and need to be treated that way. And they shouldn’t have to apologize!’