GP practices lay complaint with Commerce Commission over ‘unfair’ and ‘illegal’ contracts

• General Practice Owners Association has filed a complaint with the Commerce Commission over what it believes are “unfair” contracts.
• There are concerns Health New Zealand has the ability to “dictate” the terms of GP funding.
• General practice funding issues are putting additional strain on already overburdened hospital emergency departments.

General practice owners have filed a complaint with the Commerce Commission over “unfair” and “illegal” contracts which they argue are harming the delivery of healthcare for all New Zealanders.

The General Practice Owners Association [GenPro], which has filed the action, has also warned it’s a “distinct possibility” that more people could die in emergency department waiting rooms unless the Government urgently invests in primary care.

GenPro chairman Dr Angus Chambers told the Herald its members don’t have any true ability to negotiate how they’re funded given the Government can issue directives that practices have no choice but to accept.

He acknowledged general practice owners are “at the table” for negotiations but have “very limited ability” to influence decisions.

“The contracts imposed on us with no effective input are unfair. We believe they are illegal and breach the Fair Trading Act,” he said.

Dr Angus Chambers works at Riccarton Clinic in Christchurch. 12 September, 2024. Photo / George Heard

He said the state can compulsorily vary contracts and believed GPs had “no power” to intervene or challenge the decisions.

“We’ve asked the Commerce Commission to investigate the fairness of the contracts that GPs operate under, and we are seeking intervention from the Commerce Commission,” he told the Herald.

Chambers accepted the decision to lay a formal complaint was drastic, but said it was ultimately about trying to ensure GPs were properly funded so they could cut wait times and make GP visits more affordable for patients.

General practitioners believe proper investment in the sector would attract more GPs to the profession which would reduce staff burnout and enable patients to be seen sooner.

“GenPro has tabled the complaint on behalf of its members, but this affects the healthcare of all New Zealanders,” he said.

GP practices are funded according to the number of patients they have enrolled in a system known as capitation.

In July, the Government offered an extra 4% on the amount a practice gets paid per patient which was widely criticised as inadequate and disappointing.

Dr Bryan Betty is the chairman of General Practice New Zealand. Photo / Supplied

General Practice New Zealand chairman Bryan Betty told the Herald he understood why there were frustrations with the system.

He said the Government offer of 4% was “a lot less” than expected.

“The Government can dictate what is in those contracts or what the uplift is in capitation. There was no room to negotiate that [the 4% offer],” he said.

“A compulsory variation comes in over the top and the Government says, ‘This is what we’re giving you. That’s it’.”

The Herald asked Health New Zealand to respond to the various claims made by GenPro but it the agency’s director of living well Martin Hefford was unable to answer specific questions.

“We have not yet received a copy of the complaint and would not be in a position to comment until we have read it and had an opportunity to consider it,” he told the Herald.

More deaths a ‘distinct possibility’

Last week the Herald revealed patients at a GP and urgent care clinic in Ōtara were queuing from 6am in the cold in the hope of being seen by a GP.

Chambers said when people are queuing or have trouble getting appointments with their community doctor it puts more pressure on hospital emergency departments.

GPs are seen as the front door of the health system and a functional system ensures health issues are picked up early, debilitating illness is prevented, and people are kept out of hospital.

Referencing a patient who died waiting three hours to be seen at Rotorua Hospital’s emergency department, Chambers said such a tragedy could happen again.

“We have warned that this situation is possible and, unfortunately, it’s coming to pass.”

Health New Zealand has said it’s conducting a review of the incident.

Betty was also concerned there could be other incidents due to the “iceberg of problems” building up and he urged the Government to act.

“What we do know is those areas which are constrained in terms of general practice or don’t have enough capacity within the community sector are putting disproportionate demand on emergency departments.

“We are seeing that all over the country at the moment and this is a real, real concern. We need to address the problem of what is happening in the community in general practice at this point,” he said.

Michael Morrah is a senior investigative reporter/team leader at the Herald. He won the best coverage of a major news event at the 2024 Voyager NZ Media Awards and has twice been named reporter of the year. He has been a broadcast journalist for 20 years and joined the Herald’s video team in July 2024.