GP clinics may give way to hospitals

Clinical Director Dr Tim Parke. Photo / Janna Dixon

Late-night patients who now go to a private after-hours clinic may in future be told to go straight to the Auckland City Hospital emergency departments.

Taxpayer funding of the private clinics could be cut as a result.

For after-hours patients this would reverse the practice of many big-city hospitals of urging people to see a GP or accident and medical clinic if appropriate.

Auckland's three DHBs collectively spend $4.6 million a year to buy after-hours care from primary health organisations and A&M clinics.

They are negotiating changes with the sector centred on setting up, from July 1, a network of 10 after-hours clinics. The aim is to reduce patient fees, mainly in poor areas.

Holiday-season attendances at hospital EDs were generally well ahead of last summer's, especially at Waitakere Hospital, which had a 57 per cent rise for December.

At Waitakere this was partly due to increased opening hours, but Waitemata DHB medical chief Dr Andrew Brant also cited an influx of people with colds or needing a prescription or a dressing changed - GP-type patients. This is controversial. Emergency specialists usually argue that although they do see GP-type patients, they need comparatively little attention.

A number of patients have complained to the Herald of public holiday fees up to $112 at some White Cross clinics for unsubsidised adults.

In the negotiations, Auckland DHB says that for midnight to 8am, it will instead consider using its own children's and adults' emergency departments.

Auckland City Hospital ED clinical director Dr Tim Parke said primary care was vital but there was debate whether Auckland DHB's spending on non-hospital after-hours care would be better used by EDs and the Healthline phone advice service.

"Whether it's cost effective to keep A&Ms open after midnight is in some doubt. After 10pm, anything that happens that can't wait until the morning is probably by definition, an emergency."