In May 2023 Te Whatu Ora Hawke’s Bay secured a funding package that meant all general practices in Hawke’s Bay had the ability to offer rangatahi (youth) up to age 24 free visits to a GP or registered nurse.
The program was set to last two years but has been tightened as of September 1, 2024 – 17 months later.
Irihāpeti Mahuika, pou whakarae chief executive of Health Hawke’s Bay, said rangatahi were a priority group and the programme was implemented following youth consultation in 2016.
It had been identified that cost was a barrier restricting access to primary care across Hawke’s Bay.
“We’re disappointed with the change to funding for this service to our rangatahi, but acknowledge the financial constraints that Te Whatu Ora Health New Zealand are currently facing.”
“For our rohe, access for young people can be challenging, so it’s important we do what we can to identify and remove those barriers. We are pleased that some criteria for funded care have remained in place.”
He said reducing access to primary care meant many whānau wouldn’t access preventive care when they need it.
“We will see more people accessing urgent care and EDs, when they are much more unwell and in need of more urgent, longer care.”
Health Hawke’s Bay said they were committed to improving access to care for the whole community and would continue working with funders to advocate for more accessible primary care.
Health New Zealand Te Whatu Ora central regional manager living well Alison Russell said they had worked with Health Hawke’s Bay to reset the qualifying criteria to ensure the financial sustainability of the service.
The organisation was unable to immediately provide to Hawke’s Bay Today how much the service in its previous form was costing in Hawke’s Bay.
Zero-fees health care is funded for all children up to the age of 14 years across New Zealand.
Eligibility for zero-fees visits in Hawke’s Bay will be now limited to young people aged 14-24 who are:
- Māori and/or Pasifika
- Currently hold a community services card
- Currently resides in a quintile 5 area, and/or
- Have a diagnosed long-term condition, including, but not limited to, diabetes, renal disease, cardiovascular disease, non-asthma respiratory disease, cancer, or severe mental health disease (if there is no alternative funding available).
Dr Bryan Betty, chair of General Practice New Zealand (GPNZ), said while it was a Hawke’s Bay-specific program, and an extension of what other regions offer, the fact it had been tightened was a sign of the funding strains the health system and GP system were facing.
The College of GPs’ medical director Luke Bradford said because the program was region-specific, there were some issues with it.
“This service got put in post-Cyclone Gabrielle and it is the only place in the country to have free care for that age group.
“Any time there is cost attached to obtaining health care there is an impact on those able to seek it and the college has ongoing concerns around the shift towards cost of care being placed on the patient.
“However, geographical variation, as in this case, also leads to inequities and a worsening of the postcode lottery issues often seen in healthcare.”
Bradford said 14 to 24-year-olds were a group of patients with some of the lowest utilisation rates of GPs (as expected by their general good health) and lowest enrolment rates.
“We would encourage individuals to enrol with a general practice, where possible, as this reduces the cost of access. We would also encourage them to check to see if they are eligible for a community services card or other support.”
