Extending the GMS subsidy to nurses and NPs is not about “encouraging independent practice” nor was it intended for “non-general practice clinics” says Health Minister Tony Ryall.
Ryall issued a press release Monday night saying he has asked the Ministry of Health to work on extending the claiming of the General Medical Services (GMS) subsidy to include practice nurses, nurse practitioners and pharmacists “who work as a team to care for patients”.
The wording of the release appears to be directly aimed at dampening fear being expressed by GPs (see other News Feed story) that the move may promote or support independent nurse-lead services leading to ‘fragmentation of services’.
Ryall states clearly that the extension of the GMS subsidy to non-GPs “was not intended apply to non-general practice clinics”.
While it is seen as unfortunate that this rules out for now cash-strapped NP-lead centres serving rural or youth communities from accessing the GMS funding stream, nursing leaders are still supportive of the long-awaited extension.
Rosemary Minto, an NP and primary health nurse leader, said the move would allow primary health care teams to function more flexibly. “It recognises the capability of nurses to see people at the first point of contact – as they have been doing for years,” said Minto who chairs the NZNO College of Primary Health Care Nurses
Jenny Carryer, executive director of the College of Nurses, said GMS was a relatively small component of funding it was an essential step in establishing viability for nurses and nurse practitioners.
“This move by the Ministry is also important in that it tells nurses and NPs that all of their efforts towards increasing consumer access to services are being taken seriously at last,” said Carryer.
Ryall said the ‘proposed change’ would allow practices to claim for multi-disciplinary care in the same model used for ACC claims.
He said the way patients had been cared for by general practice teams had “changed significantly” since the GMS fee was introduced in 1993 and the current GMS claiming rules often lead to unnecessary duplication.
“For example, a young child loses their asthma inhaler while on holiday; the parents take them to the local general practice to see a nurse practitioner who is able to prescribe them a new inhaler,” said Ryall. “In order to get the GMS subsidy for seeing a child not enrolled with their practice, the GP has to attend the appointment as well, even though the nurse practitioner has provided the care for the child.”
Rules around extending the GMS subsidy were to be developed in the coming months with input from primary health care groups, including General Practice New Zealand, College of Primary Health Care Nurses, the Royal New Zealand College of General Practitioners and the New Zealand Medical Association General Practitioner Council.
The aim was for the subsidy to come into effect by the end of the year.
