General Practitioner Fees in New Zealand

General Practitioner Fees Information
A summary of key findings from five reports

Date of publication: August 2004

ISBN 0-478-25718-X (Web)

HP 3890

This report is about the affordability of general practitioner (GP) fees in New Zealand. A summary of relevant key findings is provided from the following studies/surveys:

First Report and Recommendations of the Commonwealth Fund’s International Working Group on Quality Indicators – A Report to Health Ministers of Australia, Canada, New Zealand, the United Kingdom and the United States, June 2004
Cost Barriers to Health Care: Provisional Analysis from the New Zealand Health Survey 2002/03 – Antony Raymont, Senior Research Fellow, Health Services Research Centre, Victoria University of Wellington, June 2004
Primary Health/PHO Communications Campaign Research, June 2004, Alan Wylie (PhD), Phoenix Research (PDF,
National GP Fee Survey, CBG Health Research Limited, February 2004
Information on fees notified by Interim PHO practices to be charged from 1 July 2004 to those aged 65 years and more.

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Overall Key Findings

The five studies/surveys referred to in this report all used different survey methods. As a result, none of the studies/surveys are strictly comparable. However they do show consistent themes. These are outlined below.

Before the implementation of the Primary Health Care Strategy there were significant cost barriers to accessing GP care in New Zealand. A comparative study of five countries (Australia, Canada, New Zealand, United Kingdom and the United States) indicated 20 percent of those surveyed in New Zealand reported financial barriers to getting medical care. This was the second highest rate behind the United States at 24 percent.

The New Zealand Health Survey taken in 2002 showed that three main groups of people have the greatest difficulty paying for GP services. These three groups were those living in areas of high deprivation (NZDep 9 and 10), Māori and Pacific peoples. The survey showed that 9.0 percent of those living in NZDep areas 9 and 10, 11.4 percent of Mäori and 8.0 percent of Pacific peoples decided not to visit a GP in the previous 12 months because of cost. Only 5.8 percent of the total population sampled reported the same decision. This supports the Government’s decision to start the implementation of the Primary Health Care Strategy by providing extra funding to PHOs who serve high proportions of these groups (Access PHOs).

Access PHOs, by definition, have higher proportions of enrolled people from those groups of the population with the worst health status (people from the most deprived areas and Māori and Pacific peoples). These groups also face the greatest financial barriers to care.

Fees charged by Access PHO practices are significantly lower than those charged by Interim funded PHO practices. This is true even for those age groups (children and the older people) for which the remaining (Interim) PHOs are receiving similar levels of capitation.

The February 2004 survey of all GPs showed that 82 percent of all practices did not charge children under six. A further breakdown of this figure shows that this was true for 93 percent of Access PHO practices, 78 percent of Interim and 80 percent of non-PHO.

In October 2003 funding for 6–17-year-olds in Interim PHOs was increased to a rate based on $25 per expected consultation. It was expected that most of this funding benefit would be passed on to patients by lowering fees. The February 2004 fees survey showed that fees for 6–17-year-olds without Community Services Cards (CSCs) were, on average, about $22 less than non-CSC adults. Fees for 6–17-year-olds who were CSC holders were $24.50 less than non-CSC adults.

In response to the 1 July 2004 increase in capitation funding for those 65 and over, Interim funded PHO practices have committed to fee reductions for this age group which are, on average, $23.40.

The February survey showed that fees charged by Interim funded PHO practices were, on average, slightly higher across all age groups than those charged by non-PHO practices. In July the average unsubsidised fee for patients 65 and over was $48.05 based on the fees of Interim funded practices that PHOs notificd DHBs. This indicates that there was a rise in charges since the February survey when the average fee for this age group was $43.00 (a 11.7 percent increase). One explanation for the higher fees is that when PHO practices notify future fees, they tend to review their current fee upwards before committing to it.

PHOs have now committed to notifying any further increases in fees. In addition, DHBs are able to set up a fee review committee if they consider any rises are unreasonable.

The fees to those 65 years and over notified by DHBs for Interim PHOs show some quite marked variations between DHBs. Fees are highest in DHB districts comprising the urban areas of Auckland and Wellington and generally lower in DHB districts with rural hinterlands. However there are exceptions. Fees are low in the urban Hutt Valley DHB district and high in largely rural Southland and South Canterbury.

Document availability
This document is not available in hard copy. It is only available for download from this website in Word or PDF format below. You may download and print off your own copy.

General Practitioner Fees Information:A Summary of Key Findings from Five Reports (Word, 70 kB)

General Practitioner Fees Information: A Summary of Key Findings from Five Reports (PDF, 45 kB)

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First Report and Recommendations of the Commonwealth Fund’s International Working Group on Quality Indicators – A Report to Health Ministers of Australia, Canada, New Zealand, the United Kingdom and the United States, June 2004 (link to full report on the Commonwealth Fund website)
Cost Barriers to Health Care: Provisional Analysis from the New Zealand Health Survey 2002/03 – Antony Raymont, Senior Research Fellow, Health Services Research Centre, Victoria University of Wellington, June 2004 (PDF, 94 kB)
Download the Word version of Cost Barriers to Health Care (Word, 137 kB)
Primary Health/PHO Communications Campaign Research, June 2004, Alan Wylie (PhD), Phoenix Research (warning large download: PDF, 1 MB)
Download the Word version of Primary Health/PHO Communications Campaign Research (warning large download: Word, 1.4 MB)
National GP Fee Survey, CBG Health Research Limited, February 2004 (PDF, 179 kB)
Download the Word version of National GP Fee Survey (Word, 529 kB)
Information on fees notified by Interim PHO practices to be charged from 1 July 2004 to those aged 65 years and more. (PDF, 14 kB)
Download the Word version of Information on fees notified by Interim PHO practices (Word, 29 kB)