Hawke's Bay District Health Board first to give free GP visits to under-18s

Free GP visits for some under the age of 18 in Hawke's Bay will be rolled out early next year.
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Free GP visits for some under the age of 18 in Hawke's Bay will be rolled out early next year.

A historic decision by Hawke's Bay District Health Board will see free GP visits extended to under-18s in selected practices.

Wednesday's decision marks the first time a DHB has extended free GP visits beyond the Government's policy to have free primary healthcare for those under 13. 

The plan, which is due to be introduced early next year, will aim for all under-18s enrolled in 14 selected practices in the region to have free visits to their doctors. 

Royal New Zealand College of General Practitioners president Tim Malloy has welcomed the decision by Hawke's Bay ...
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Royal New Zealand College of General Practitioners president Tim Malloy has welcomed the decision by Hawke's Bay District Health Board.

The practices chosen, which have the choice to opt in or out of the scheme, have a high number of Maori and Pacific patients.

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DHB performance, informatics and finance manager Tim Evans said the hope was young people would form a relationship with their doctors from an early age. 

"We think it will have a good impact, and youngsters will go see their primary healthcare team earlier.

"We think it will improve their health outcomes, and in terms of the overall system, it means fewer of them turning up to ED to access free healthcare.  

"If we are right, and those things actually happen, we are on to a winner."

Board member Ngahiwhi Tomaoana said it was good moment for the health board. "This is one of those yahoo moments ... I am proud of these moments."

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In the Wellington region, the Capital & Coast and Hutt Valley DHBs each said they funded some free health services for young people, but were not looking at free GP visits. 

The Hawke's Bay programme is expected to cost $583,235 a year, and will cover about 70 per cent of the 13 to 17-year-olds from Wairoa to Central Hawke's Bay.

There are approximately 11,096 children in that age group enrolled in general practices across the region.

"We looked at the costs of providing free visits for all of our 13 to 17-year-olds, but that was a bit too expensive to bite off in one chunk," Evans said. 

"We decided to select those practices which have the highest proportion of Maori, which is the practices in the most deprived areas. We know deprivation, reinforced by ethnicity, drives poor health, and poor health outcomes." 

If successful, the DHB hopes eventually to extend it to all under-18s. It would be closely reviewed throughout 2017 to see if it was working. 

"I would hope the benefits we see from this would see us offering this to all practices throughout the region," board chairman Kevin Atkinson said. 

In Hawke's Bay, consultation fees for the age group range from zero to $42. Those practices that opt into the scheme would be reimbursed for each visit by the DHB.

Royal College of General Practitioners president Tim Malloy said cost was definitely a barrier for teenagers accessing healthcare.

"This is a group who aren't historically used to engaging with primary care. In that sense, the removal of a cost access barrier has to be applauded.

"The possible quid pro quo of being successful is it increases utilisation to the point where general practice services can't reach the demand. 

"At least patients are attempting to get care, and overcome the access barrier of cost."

Hastings district councillor and Flaxmere stalwart Henare O'Keefe said extending free healthcare was a step in the right direction. 

"I think it has got to be a good thing, being proactive. It is an investment rather than a liability," he said. 

O'Keefe said all health providers and social services needed to "up their game" to engage youth in lower socio-economic areas. 

"Maybe we may have to move our GP setting to a marae, to a mutual territory," he said.  

 - Stuff

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