03/10/2024
This is not a post we want to make, but unfortunately we have been left with no alternative this far. Most of our enrolled patients will already have received this email but for those that haven't we have pasted it below for you.
Dear valued patients,
We want to share some important updates regarding our services at Fiordland Medical Practice.
Like many medical practices across New Zealand, we are feeling the strain of insufficient government funding. It's disheartening to witness the closure or reduction of services in medical centres nationwide, after-hours care, due to financial constraints. Unfortunately, we at Fiordland Medical Practice have not been immune to these pressures and the current reality is that we are operating at unsustainable levels.
We want to preserve the breadth and quality of services we offer, but without necessary changes, our ability to do so is at risk.
Capitation is the government’s way of providing primary care with a predictable, set amount of money for each patient enrolled with a practice. For the past 19 out of 20 years capitation has failed to meet inflation, a problem that continues to snowball this year. Health NZ advised Dr Shane Reti (Minister for Health) in January that there was a 14% capitation shortfall in 2024. Only a 4% increase has been announced. New Zealand spends 5.4% of its healthcare budget on primary care compared to an average of 14% across the OECD.
Rural practices, such as Fiordland Medical Practice, operate on a 24 hour / 7 day per week basis to provide urgent and complex care services that would be provided by an Emergency Department in an urban setting – these departments receiving far more funding and free access for patients.
Additionally, our clinicians are PRIME responders (Primary Response In Medical Emergency), assisting with 111 call outs for cases of high acuity or when the local ambulance is busy attending another call or undertaking the approximately five-hour return trip to Southland Hospital, for example. The base funding that we received for PRIME amounts to $2.16 per hour, from which we are expected to provide an on-call clinician 24/7, train our staff (full day course for seventeen doctors and nurses every two years – after a full week initial training with associated travel and accommodation), pay for a practice vehicle, and check plus restock equipment and medications.
In addition, here in Te Anau we provide the majority of crewing for the Air Rescue Helicopter. This generates considerable further pressures on staffing and associated training. However it is a resource we are committed to maintaining and we understand that the community support us in this.
Unfortunately, we have been told by the government that the only way to make up for the shortfall between capitation funding and the actual cost of providing healthcare is to increase our patient fees. We join with the rest of the primary care community in being deeply distressed by this decision at a time when many of our patients are already struggling with the cost-of-living increases.
In line with this from 14th October, we will be implementing adjustments to our fee structure to help alleviate some of the Practice’s financial strain and ensure we can continue to maintain a quality 24/7 service for our community . We understand that any changes in cost can impact our patients and want to give you notice of these.
There will be no charge for a standard consultation for enrolled patients who are under 14 – although we still don’t receive sufficient funding for taking blood test or doing X-rays so will still charge for these services.
We have reviewed our nursing time, dressings, and procedure prices, ensuring they now reflect the actual costs involved. We have enclosed an updated price list for your information. This covers the basic services. Please remember that a ‘consultation’ is up to 15 minutes. Please be considerate of the doctor and other patients by sticking within this time or advising the reception staff when you book if you need a longer appointment or need something additional like a Driver’s medical (for which we need to book you with the nurses first).
We understand that these changes may pose challenges for some of our patients. We want to reassure you that your access to healthcare is a priority for us. If you find yourself in a situation where paying for medical services is a concern, please don't hesitate to reach out to us. We are more than willing to work with you to explore payment plans. The staff in Community House also know about funding options (in the building in front of the Health Centre).
In additional to increased fees, the practice may not be able to provide face to face care 24 hours a day. After hours you may be diverted to the Ka Ora telecare where a nurse will take your phone call. A local doctor remains available 24/7, but to limit fatigue and improve access, you may be diverted to Ka Ora. This is the system being used across the country, including in areas with many times the population of Te Anau. We are proud to have provided 24 hours care for decades but it is our single biggest burden – not only financially but in impact on our ability to work safely the next day.
If you feel as disappointed as we are with Health NZ’s decision, we ask that you email Dr Reti at S.Reti@ministers.govt.nz and share your concerns.
Thank you for entrusting us with your care. We remain committed to serving you with compassion, integrity, and the highest standard of care we can in a resource-constrained environment.
Nga mihi
Fiordland Medical Practice
25 Luxmore Drive, P O Box 94, Te Anau 9600, Southland
T: 03 249 7007 | E: office@fiordmed.co.nz (secure email)
Note: All information in this email message is legally privileged and confidential. If you are not the intended recipient, or believe you may not be the intended recipient, you are hereby notified that any use, dissemination, distribution or reproduction of this message is prohibited. If you are aware you have received this message in error, please notify us and delete all copies of this message. Thank you for your co-operation.
FMP GUIDELINE OF FEES - 14 October 2024
MEDICAL
Registered and Enrolled
Under 14 years
free
14-17 years
$40.00
18 years +
$60.00
CSC Holder - Under 14 years
free
CSC Holder 14-17 yrs
$13.00
CSC Holder 18 years +
$19.50
REPEAT PRESCRIPTION
$18.00
PRESCRIPTION SAME DAY
$28.00
JOINT INJECTION (Additional)
$40.00
Saturday Clinic (additional)
$5.00
Sunday/Public Holiday (walk in clinics) additional
$15.00
ACC CONSULTATION GP/NURSE
Under 14 years
free
14 years and above
$40.00
CSC Under 14 years
free
CSC 14-17 years
$13.00
CSC 18 years+
$19.50
X-ray ACC only
$80.00
NURSE CONSULTATION - BLOOD/BP CHECK
All ages (with or without GP appt)
$15.00
All ages with GP appt CSC or HUHC
$10.00
NURSE CONSULTATION - OTHER
Injection (B12/Zoladex etc.)
$30.00
Liquid Nitrogen (all ages)
$22.00
Earcare Initial
$65.00
Earcare
$50.00
