How much do urgent care fees vary within 21km in Auckland?
Urgent care is accessible but the fees, and the wait times, are quite varied around the Auckland.
Photo:
RNZ
It's lunchtime on a Tuesday at the White Cross
urgent care
clinic in the south Auckland suburb of Otāhuhu.
"Today is our fourth time in four weeks and today we've had to pay $150. So the twins are free, but me and my partner is $65 each."
A mother told me the family had to come back to the clinic for another prescription, because sickness was spreading at home.
"The virus that my daughters have caught doesn't go away unless you get antibiotics. And now we've caught it so we need antibiotics too, which their antibiotics won't work for us. It's just getting worse and worse. And if they get better and we've got it, we just end up giving it (the virus) back to them."
The Otāhuhu clinic is close to home for the family, and it's cheaper than other urgent care clinics.
"This is the most affordable one to take us in this fast. Our Local Doctors (a GP clinic) can't take us in for another three weeks. The last time we've been to the doctors for ourselves was probably two years ago. We just tough it out because it's too much amongst all the other bills that we have to pay.
"Today we're gonna have to cut short on food. We haven't done our grocery shopping for the week yet, so it's gonna be what the twins need, and then whatever's left."
By "take us in this fast", the mother meant: "eight hours with two two-year-olds, gonna be great."
As part of the Budget this year, Health Minister Simeon Brown promised greater accessibility to urgent and after-hours healthcare in the regions, with several new 24-hour services planned around New Zealand.
Health Minister Simeon Brown.
Photo:
RNZ/Marika Khabazi
Meanwhile in Auckland, urgent care is accessible but the fees, and the wait times, are quite varied around the city.
Three hours later, I crossed path with the family again - 7km away at the White Cross clinic in Mount Wellington.
At White Cross Otāhuhu, the cost for an un-enrolled adult without a community services card is $70. Meanwhile in Mount Wellington, the fee is $130.
The mother said they were sent by staff at Otāhuhu to Mount Wellington at no extra cost, so their wait could be shortened by half.
They told me the Mount Wellington waiting room is much quieter than Otāhuhu.
Further south, the cheapest White Cross clinic is in Manurewa, where an un-enrolled adult without a discount pays $60, and $15 if ACC offers cover. Enrolled adults pay $18, and if they've got ACC coverage, it's free.
It's an attractive price for many patients.
A woman told me this is the cheapest clinic that she knows of, and she drove 10km that day to see the doctor.
"Just for a follow up, it's $18."
Another man told me the price is vastly different between two clinics 9km apart.
"In Takanini, I think the charge for a repeat prescription is around $15 to $20, but here it's around $7 to $10."
Meanwhile in Remuera, one of Auckland's affluent suburbs, the White Cross Ascot 24/7 charges $130 - more than double the $60 charged in Manurewa.
A couple who just finished their consultation told me they are enrolled with the Tāmaki Health network, so it cost them $80 in Remuera.
They say their bill could be cheaper if they travelled to a clinic further away, but in this case, they think their health is more important than the money they could save.
"It was $80 because I was in pain, and this was the nearest hospital from my work," the woman said.
"Where we go most of the time, it's about $17 or $18, then if it's after 5pm, that's $35. But she was working here, so it was convenient for her to come here," her partner added.
Their wait that day was two hours.
Malcolm Mulholland from Patient Voice Aotearoa said cost was the number one factor in determining whether patients access healthcare.
"I know that there are a number of families and patients out there who won't go and see their GP, primarily because of cost. And when that situation does arise, what tends to happen is as the patient's health deteriorates, they end up going to the ED and that's why we are seeing ED with record number of patients."
Mulholland said many factors play into how practices price their fees: location, competition, demand and funding level are just a few.
He lives in Palmerston North, where there is only one after-hours clinic. It costs $210 to see a doctor during normal hours, and $240 on weeknights.
The Palmerston North clinic also belongs to Tāmaki Health, which manages the White Cross network of urgent medical clinics.
Tāmaki Health declined to comment, or provide a statement for this story.
I asked Mulholland if there's anything patients can do to cut their bill.
"Sadly not. I don't know if there is much that patients can do other than try to be seen during the day. But again, you're gonna run into problems with GP practices being full and then the wait time to see a GP.
"I think that's a really sad state of affairs because you're essentially asking patients to triage themselves and patients won't always make the right decision."
And Mulholland said it all came back to the desperate need for more doctors.
"Patients are worried about their health. They can't get access to a GP or a doctor, whether that be during the normal working hours or via an ED. And so they're going wherever they think they might be seen."
In May, the government announced a $164 million investment in urgent care. As part of the improvement, the agency noted it would implement a nationally consistent fee and subsidies schedule.
In a statement to First Up, director of Living Well at Health New Zealand Martin Hefford said, "Health New Zealand is shifting from a fragmented system with wide fee variation to one that's more transparent and predictable across the country."
There would still be some variation of fees, Hefford said, but the details were not finalised yet.
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