Patients 'will get sicker'

BY RBEBECCA TODD
Last updated 05:00 29/03/2010

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Vulnerable patients will get sicker and more will go to hospital under proposed funding cuts for family-doctor groups, a health leader says.

A "double whammy" of health cuts was looming, said Kathy James, clinical adviser at Health Care Aotearoa (HCA), a network of community-driven primary healthcare services.

She said the Government had told primary health organisations (PHOs) – the groups that contract family doctors – to save $24 million, and district health boards were cutting back on contracts in a bid to manage their deficits.

The "so-called savings" were meant to be from backroom functions, but small PHOs serving high-needs groups tended to be highly efficient, meaning savings would have to come from frontline services, James said.

"Frontline services will decrease for vulnerable populations," she said.

"People will have to go to the ED (emergency department) more often. They will get sicker and will be admitted, so we'll see a rise in avoidable hospitalisations, which is one of the things the Government is keen to reduce."

A HCA analysis found organisations serving at least 100,000 "non-high-needs" patients would have a funding reduction of just 0.56 per cent, equalling a reduction per patient of 64 cents.

Small organisations with enrolments of about 20,000 "very high-needs" patients would have a cut of 8.6 per cent – a loss of $20 a patient.

"It really makes the small practices unviable overnight," James said.

"The irony is that small PHOs really give primary care its vibrancy and diversity and are highly successful."

She said the experience of the Canterbury Community PHO was a sign of things to come nationwide.

It recently lost special population funding from the health board, meaning Union and Community Health, which serves a large Maori, Pacific and refugee population, had to close one of its clinics, make two health workers redundant and cut GP and nursing hours.

"Christchurch seems to be the one where it's being played out ahead of everyone else," James said.

HCA has sent its report to Health Minister Tony Ryall.

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