Primary Care Fees Framework

Since July 2002 the Government has invested over $2.2 billion in new funding for primary health care.  Most of this funding has gone into reducing the cost of visiting a GP for all New Zealanders.

This funding has been released through a series of funding tranches attached to particular age groups.  The young and the older age groups were the first to receive the benefits of reduced costs when visiting a GP.  Last year was the turn of the 45-64 age group, and this year, the final age group of 25-44 will receive funding from 1 July 2007.

As part of the funding rollout for 45-64 year olds last year, the Minister of Health has asked that DHBs and PHOs negotiate changes to the existing Fees Framework in three areas:

• Greater clarity about the fee reductions that will result from the increased funding for 45-64 year olds in July this year.
• Transparency of fees information so that people can easily see information about what practices in their community charge.
• A more robust fee review process to ensure that subsequent fee increases are reasonable for patients and providers.

The DHBs and PHO finalised a new fees framework last year in time for the 1 July 2006 funding rollout for 45-64 year olds.  The new fees framework included PHO agreement to make all GP fees available to their local communities and a flow through criteria that PHOs need to meet for each of their General Practices to qualify for the new funding.

In addition, the DHBs and PHOs agreed to an annual review process that would establish a level of reasonable GP fee increase each year.  This process is set out under Annual Statement of Reasonable GP Fee Increases.  They also agreed to a new fees review process which is set out under Regional Fees Review Committees.