New 'scholarships' to fund new grad nurses to work in high needs communities are being welcomed, but the Health Minister’s "slip" in talking only about "low-cost doctors' visits" is not.
Health Minister Tony Ryall announced late last month a $1.5 million scholarship fund to support 30 new graduate nurses to work for a year in general practices that are part of the Very Low Cost Access (VCLA) scheme.
At the same time, he announced an extra $4 million a year to support some of the nearly 300 general practices offering "low-cost doctors’ visits" to some of our “most vulnerable communities” under the VCLA scheme.
Professor Jenny Carryer, executive director of the College of Nurses, welcomed the scholarships and extra funding but said it was “disappointing” to see the minister talking only of “doctors’ visits”.
She said general practice has been at “great pains” to move towards a team approach so that patients received care from the most appropriate member of the workforce “be that a general practitioner (GP), a nurse practitioner (NP), or a primary health care nurse”.
“It is to be hoped that this (is a) slip in terminology and that the funding is indeed available to support the spectrum of care,” said Carryer.
She congratulated the Minister for recognising the importance of “pre-emptive” primary health care for those living with financial deprivation. She also said the scholarships to support new graduates into VCLA practices for a year was an “excellent move” to ensure the sector was “growing replacements” for the large number of nurses drawing close to retirement age.
The scholarship move has also been welcomed by the Rural General Practice Network with chair, Dr Jo Scott-Jones, saying the network was excited about the prospect of seeing more new graduate nurses being supported to work in primary care, which was currently a “poorly supported” nursing specialty.
He said approximately one-third of rural practices were VCLA practices.
“We would hope that this initiative will start a trend that will see more new graduate nurses not only entering primary care where they are sorely needed but also looking at high needs rural practices.”
Ryall said the extra $4 million a year for VCLA practices was to be allocated to primary health organisations (PHOs) that would work closely with their district health board and the ministry to distribute the funding to VCLA practices in need of extra support.
The Dominion Post reported prior to the Minister’s announcement that the Hutt Union Health Service was fighting to keep its Petone clinic open after losing contracts in recent years and that other low-cost clinics in Wellington were also under considerable funding strain. It quoted Newtown Union Health Service manager and WellHealth trust board PHO chair Fiona Oston, saying that there was a “real risk” of lost-cost practices falling over and that many doctors and nurses were already working voluntary overtime.
The VCLA payment scheme was introduced in October 2006 for PHOs and practices that meet and maintain very low fees as they typically serve high need communities and are endeavouring to “reduce health inequalities” by forgoing revenue from patient fees.
Ryall said funding for the scheme had increased from $27 million in 2007-08 to $50 million this financial year. He also said latest data from the Ministry of Health showed that 1.3 million people were enrolled with clinics offering “low-cost doctors’ visits” including 75 per cent of Pacific people and 56 per cent of Māori.
The VCLA scheme information on the Ministry of Health site says the funding is for practices that reduce their fees for standard consultations and does not specify who carries out the consultation.
