Hospitals propose preferential treatment

The proposal has alarmed hospital doctors and nurses who fear that it would create 'two classes' of patients in the public system. Photo / NZ Herald

Two district health boards propose to offer public hospital patients the option of paying for treatment that is not funded by the public health system.

The proposal has alarmed hospital doctors and nurses who fear that it would create "two classes" of patients in the public system.

But Health Minister Tony Ryall said the idea merited investigation and could be applied nationally.

The Otago and Southland DHBs have invited public comment by next Tuesday on their plans to offer additional treatments at a cost to patients.

The boards' consultation paper, available on the Otago board's website, says the number of patients who might pay for additional treatments is expected to be small. And it asserts that other patients will not be affected.

"Patients who receive additional unfunded treatments will not be able to queue-jump a waiting list by paying for a higher priority," it says.

The proposal has echoes of the previous National Government's short-lived scheme for hospital part-charges in the early 1990s under Health Minister Simon Upton.

Mr Ryall was anxious to distance the proposal from Mr Upton's scheme. "The National Government has always said we are not introducing part-charges in our public hospitals," he said.

The two boards believe their scheme will benefit the likes of cancer patients who have not responded to state-funded treatments and might purchase newer, unfunded medicines.

Before Herceptin was state-funded for women with HER 2-positive early-stage breast cancer, some sufferers paid more than $100,000 at private clinics for a standard 12-month course.

Mr Ryall said the idea, which would need his final approval, merited investigation as long as it would help patients - without leading to queue-jumping or imposing extra costs on public hospitals. If successful, it could be applied nationally.

Unions representing nurses and senior doctors are unhappy about the idea. "The principle of having a dual system of publicly and privately funded care being provided in the public sector is fraught and runs the risk of public patients being disadvantaged," said the Nurses Organisation.

"It will also create dilemmas for professionals who are asked to offer different treatment options, depending on ability to pay."

Organising services manager Cee Payne said workloads were already high. No spare capacity existed for delivering additional services. If spare capacity did exist, it should be used to improve services.

The Association of Salaried Medical Specialists' president, Dr Jeff Brown, said National's experiment with hospital part-charges had left "an ugly taste" and he was "extremely wary" of the proposal.

"We have major problems with capacity in public hospitals at the moment. If there's something that's available and not funded publicly ... how could it be established in the public system without capacity issues, staffing issues and cost issues."

Labour's health spokeswoman, Ruth Dyson, dismissed the assertion the proposal would not lead to preferential treatment. "There are only so many doctors and nurses to go around and they should be available to help all people who walk through the public hospital doors on an equal basis rather than being tied up with paying patients first."