Latest news with #GPfunding
RNZ News
6 days ago
- Health
- RNZ News
GP funding changes will worsen Māori health inequities, expert says
The GP funding changes are proposed to take effect from 1 July 2026. Photo: RNZ A public health expert says the government's updated funding formula for general practices will fail to address the country's biggest health inequities because it excludes ethnicity. From July 2026, GP clinics will receive funding based on factors such as age, sex, rurality, socioeconomic deprivation and morbidity. The changes are intended to replace a 20-year-old model that largely used age and sex to determine funding levels. But public health senior research fellow at Otago University Dr Gabrielle McDonald said the government had ignored expert advice to also include ethnicity, despite strong evidence it was a powerful indicator of health need. "It's illogical," she told RNZ. "Leaving ethnicity out means [funding is] not going to be allocated to those highest areas of need, which will make accessing health care more difficult for Māori and Pacific communities." McDonald said data showed Māori lived seven years less than non-Māori and had higher rates of many serious illnesses, including cancer, even when poverty and other social factors were taken into account. "There's a lot of data that shows Māori don't get as good a deal from the health system as non-Māori. We've got a system that doesn't respond to Māori and Pacific people, it's geared towards the so-called majority Pākehā," she said. The funding formula is used to allocate money to general practices based on the characteristics of their enrolled patients. A 2022 government commissioned analysis by consultancy Sapere recommended it should include age, sex, ethnicity, deprivation, morbidity and rurality. "It was very thorough and they produced a high-quality report and put ethnicity in the funding formula because there was evidence to support that. "And so the government has said, yes, that's good, we will use that formula, but they've taken the ethnicity out, which is illogical," McDonald said. McDonald said removing ethnicity would make it harder to reduce inequities in primary care, which acted as the "gatekeeper" to the rest of the health system. "We know that general practices are the backbone of any good public health service. "Measures that don't aim to reduce inequities at that spot mean you're going to be playing catch-up throughout the health system if you can't reduce inequities in accessing primary care." She said including ethnicity was "highly justified." "We know our health dollar is really scarce and it needs to be spent where it's most needed. Leaving ethnicity out means it's not going to be allocated to those highest areas of need, which will make accessing health care more difficult for Māori and Pacific communities." McDonald has been a public health physician since 2011 and is a Pākehā researcher at Kōhātū - the Centre for Hauora Māori at the University of Otago. She has worked as a doctor for about 25 years, including extensive experience reviewing child and adolescent deaths. "I've spent a large amount of time reviewing child and adolescent deaths, and the inequity is very, very obvious there," she said. "Māori and Pacific children bear the brunt of many of the negatives of living in our society and they pay for it with their lives. We've got inequity in death rates for children and adolescents in almost all areas." Minister of Health Simeon Brown says Māori and Pacific peoples, in particular, will benefit from the updated GP funding model. Photo: RNZ / REECE BAKER In a statement to RNZ Minister of Health Simeon Brown said too many Kiwis were waiting too long for a GP appointment. "The current funding model is outdated and doesn't fully reflect the needs of patients," he said. "That's why we're making changes to the way GP clinics are funded to ensure money goes where it's needed most, with the revised formula going beyond age and sex to also factor in rurality, multimorbidity and socioeconomic deprivation." GP clinics serving communities with higher health needs would receive more funding to care for their patients, he said. "The reweighted formula recognises the impact that age, rurality, complexity and deprivation have on health outcomes, and will ensure resources are targeted to those with the greatest need. "Māori and Pacific peoples, in particular, will benefit from this change." The changes are proposed to take effect from 1 July 2026. Public health physician and Otago University research fellow Dr Gabriel McDonald says data shows Māori often face extra hurdles getting the right care and the same treatment as non-Māori, even when poverty is factored in. Photo: Supplied / Gabrielle McDonald However, McDonald said she expected the government to implement a "state-of-the-art, fully fit-for-purpose formula," but that the final version "ignored the ethnicity funding factor". "We know from the data that outcomes are not the same for Māori and non-Māori, even when you take into account poverty and other factors. "Māori face additional barriers to accessing care, to accessing appropriate care, and to receiving the same level of treatment once they do access care. There's a lot of data showing Māori don't get as good a deal from the health system as non-Māori." "And then there are the determinants of health, things like poverty, level of education and other factors, which we know are not equally distributed, with Māori marginalised in almost every area." She also believed the decision reflected a wider trend in government policy. "There's a lot of pushback to talking about the needs of ethnic groups, even where there's really good reason to pay attention to ethnicity." She argued the government should adopt a complete, evidence-based mechanism for funding general practices, rather than the partial formula announced, to align with its stated goal of needs-based funding. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
BBC News
04-07-2025
- Health
- BBC News
GP partners in Northern Ireland vote for collective action over funding
GP partners in Northern Ireland have voted in favour of taking collective action as part of their fight for increased funding for general 80% of GP partners who are British Medical Association (BMA) members took part in the ballot of which 98.7% voted in favour of medics' trade union said this will see GP practices withdrawing some non-funded services which will take time away from patient NI GP committee chair, Dr Frances O'Hagan, said the result sent a "clear and unequivocal message" to Health Minister Mike Nesbitt. "We have been warning for well over a decade now that general practice was not being funded to meet the needs of growing patient lists and that failure to act on this would have consequences on patient care," she said."Frustratingly, these warnings have fallen on deaf ears." Dr O'Hagan said the health minister "wants to shift healthcare services into the community where general practice sits at the core" and hopes to achieve this "by imposing an under-funded contract and publicly dismissing GPs' valid concerns on how this will impact patients in these very same communities". "It is demoralising and has left GPs with no choice but to vote in favour of collective action."Dr O'Hagan said the "imposed contract would serve to work against improving patient access". GPs 'left with no choice' She called on the health minister to "act urgently" and resume contract negotiations."Not one GP who voted in favour of collective action wants to have to go down this road, but they feel they have been left with no choice."The minister needs to demonstrate that he values general practice and that he has our backs by coming back to the negotiating table with an improved 2025/2026 contract offer." The BMA had made a number of proposed collective actions in relation to the included:Limiting daily patient consultations per clinician to the UEMO (European Union of General Practitioners) recommended safe maximum of 25Serving notice on any voluntary activityCeasing completion of unfunded paperworkSwitching off Medicines Optimisation Software In a statement on Friday morning, the Department of Health said it had "not yet received formal confirmation from the BMA of the outcome, nor of the specific measures that will comprise the collective action".It said that it would be "important that GPs continue to adhere to the terms of their contract while taking any action, that there is no negative impact on patient safety and that access to service are maintained"."The department recognises that primary care system is under considerable, sustained pressure and GPs and their teams are working hard but are struggling to meet the demand from patients."It added that the financial challenges facing the Department of Health are well-known and in "that context, the £9.5m in additional funding included in the 2025/26 GMS contract represented the best possible offer the department could make for 2025/26"."It is a matter of regret that the department has not been able to reach agreement in relation to the 2025/26 GMS contract."The department said the health minister "remains open to discussion as to how best to secure the future of general practice so that it can remain a central part of primary care services now and in the future". It said it had "already written to NIGPC inviting them to engage in formal negotiations to develop a new GMS contract", and that it "has not yet had a response to this offer".
BBC News
26-06-2025
- Health
- BBC News
GPs in 'formal dispute' with ministers over £290m funding gap
Doctors have entered a formal dispute with the Scottish government, the British Medical Association (BMA) Scotland has union has called for "full restoration" of a £290m funding gap for GP surgeries and said the next step would be to ballot doctors on disruptive said the share of the health service budget has fallen against inflation every year since 2008, and surgeries cannot afford to hire the staff they Scottish government said it was taking forward discussions with BMA Scotland "to avert escalation of this dispute". A joint statement from Dr Iain Morrison, Dr Chris Black and Dr Al Miles from BMA Scotland's GP committee said doctors faced "significant challenges" in delivering core services. It said: "The ridiculous paradox of GP Partners having to look at what hours across the practice can be reduced in order to balance the books, at a time of more demand on services than ever before, must stop. "The impact this is having on the locum market and job opportunities, especially for our newly qualified GPs, is shockingly stark." The union said it would launch a "Stand with your Surgery" campaign for £290m to come back directly to GP practices. It said the declaration of the formal dispute was the next legal step in escalating concerns in preparation for a ballot on "disruptive action".Dr Iain Morrison added: "I want to make it clear, no one wants this escalation to take place. "Urgent talks with the Scottish government continue to identify how they can work with us to provide full funding restoration and exit this dispute."Research by BMA Scotland suggests the funding which GP practices receive for every patient has been eroded year after year against inflation since the Scottish government said it has increased investment and was determined to increase the number of GPs in Secretary Neil Gray said: "The Scottish government values greatly the work of general practice and is actively taking forward discussions with the BMA over this summer to avert escalation of this dispute and address the BMA's concerns."The BMA entering into formal dispute with us will not affect the care patients receive".
