June 17 2022 To:
Keriana Brooking, National Director of Commissioning, Health New Zealand
Cc:
Hon Andrew Little, Minister of Health Fepulea’l Margie Apa, CEO, Health New Zealand Riana Manuel, CEO, Māori Health Authority
Via e-mail
Tēnā koe Keriana, We are writing to outline our concern and frustration at both the content of the Prescription Notice for 2022/23 and the process around its issue. There is understandable disappointment around the uplift that has been confirmed for the year ahead, in particular the absence of the higher 30% increase for immunisation fees for Māori and Pacific people which had been part of the original offer made to PSAAP on June 1. We were also still hopeful that the offer made in the meeting to increase Services to Improve Access and Health Promotion funding by 3% would have been retained, given the relatively small quantum of the national health budget involved. Although the PSAAP meeting ended without agreement when the Provider Caucus declared it had no mandate to continue, we believe that there were options available within and alongside the PHOSA to secure both the higher equity adjusted immunisation payment and the SIA and HP increases. The fact these were not explored, alongside a disappointing capitation uplift, means that there is likely to be a real and immediate impact on the ability to sustain and develop services that improve equity and wellbeing in local communities. You will be aware that, following the Prescription Notice, PHOs have already started receiving formal ‘notification of problems’ letters from provider practices. In many cases these letters have been received even before PHOs themselves have received the Prescription Notice, confirming the continued lack of engagement with the PHOs that are party to the Agreement and instrumental in primary care development and delivery. These letters are indicative of the mood in general practice at the moment. The headlines in recent days in relation to ‘closed books’ and delays in accessing appointments reflect the huge workforce and capacity challenges already experienced by general practice. The Prescription Notice will do nothing to alleviate those challenges and the consequences for the entire system – essentially patients, and particularly the most vulnerable, suffer. PHOs, as always, are a crucial part of the solution in this challenging period. We will continue to do everything possible to ensure that essential primary care services are provided, to support and encourage