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Patients are being charged up to $250 to see a doctor after hours, a Ministry of Health survey has found.
The survey is contained in a report to the Cabinet on "the problem" of high patient fees for after-hours primary care, which says it is more widespread than previously thought.
The $250 fee was the highest found, and the report says that this amount "is rarely charged" by the unnamed clinic concerned.
The survey found that around 50 clinics were charging "high" fees of more than $15 for casual consultations for children under 6. Nineteen were charging these rates even for young children enrolled with a primary health organisation (PHO).
More than 40 were charging "high" fees of more than $45 for children aged 6 to 17, although clinics may appear in multiple categories of the survey.
All clinic names are blacked out from the report, dated last October and obtained by the National Party under the Official Information Act.
National's health spokesman, Tony Ryall, said last night: "You'd think that having a huge ministry and 21 district health boards working on this for over two years, more progress would have been made."
The Government has poured $2.2 billion into primary healthcare in the past seven years, mainly to reduce patients' fees, but after-hours care - covering nights, weekends and public holidays - has never been comprehensively addressed.
Health boards are only slowly implementing after-hours plans. In some places this involves GP clinics at public hospital sites and one board wants its local PHOs to pay into an after-hours fund. Another has put more money in to reduce after-hours fees, yet they are still at levels considered high by the ministry.
Going to an after-hours clinic can be the only option for some families where both parents work during the day or which have one car which is used by a working parent.
"The biggest issue is that children get sick 24 hours a day and places are open 10 to 12 hours a day," said GP and Child Poverty Action Group spokeswoman Dr Nikki Turner.
"We think it's unacceptable there's any barrier to primary health care for a child. It's a very short-sightedpolicy."
The report says after-hours fees are outside the "fees framework" by which the Government exercises control over daytime fees. It adds that PHOs maintain they are inadequately funded for after-hours care although based on patient-visit numbers from health boards, "arguably PHOs have received surplus first contact funding that could be contributed to after-hours services".
PHO Alliance chairman Hamish Kynoch said after-hours costs were rising and had not been taken into account in the bulk-funding formula.
A spokesman for Health Minister David Cunliffe said last night that every DHB was expected to develop an after-hours care plan with the GPs and PHOs within its area and so far 19 had developed their plans.
* High-priced care
The Ministry of Health says "high" patient fees for an after-hours consultation are $15 for children under 6; $45 for school-aged children; and $65 for adults.
Its survey found that for after-hours visits, at least 10 primary health clinics charged:
$41 or more for under-6s.
$66 or more for children aged 6-17.
$86 or more for adults.
