National signals limits on cheap doctor visits

National appears set to reverse plans to provide cheaper doctors' visits for all New Zealanders as it works to cut health spending.

Instead it would subsidise low- income earners, probably through a revamped community services card.

Health Minister Annette King said that would be a major setback for the public and the health sector.

"If the tax cuts are going to be paid for in health by not implementing the primary health care strategy, the big losers will be middle-income earners."

But National health spokesman Paul Hutchison said that although the existing system would be carefully evaluated before changing it, it was best to target money at those in particular need.

National is not planning to unveil its health policy for several weeks, so Dr Hutchison said he could speak "in principle" only.

Under the Government's strategy, by mid-2007 all people visiting Primary Health Organisations will have subsidised doctors' visits, cutting fees from an average of $50 to $25. Many already get the subsidy, which was introduced first for high-need groups such as the elderly. Standard prescription charges would drop from $15 to $3 with the subsidy.

Dr Hutchison said the "philosophical decision of the Government to go for universal funding" was wrong.

It meant the "Helen Clarks and Don Brashes of this world get the same subsidy as a mother of five who can't afford to take all her teenagers to the doctor or who hasn't got a choice of breast cancer drugs".

"That's the primary thing we should be talking about in this debate ... Why should those who can easily afford doctors' visits have the same subsidies as those who are struggling?"

National leader Don Brash this week committed the party to spending the 2005-2006 Budget allocations for health and promised to increase the spending in each of the following two years.

But he did not commit the party to the new baseline funding of $4.09 billion over four years set aside by the Government for health and has conceded National is unlikely to spend that much.

He said that if National won the election, it would engage in a "major exercise to reprioritise spending".

Dr Hutchison yesterday signalled that National was looking at reinstating more widespread use of the community services card or a similar mechanism.

Asked to confirm if this would be announced as part of National policy he said: "That's one of the things we'll announce in due course."

Mrs King said abandoning the subsidy roll-out would "cost more in the long term".