A Government proposal may reduce the frequency of GP visits for prescriptions. Photo / Tom Baker
A Government proposal may reduce the frequency of GP visits for prescriptions. Photo / Tom Baker
The Government is looking to extend the term of repeat prescriptions, allowing patients to wait as long as 12 months before seeing a doctor again to get a new prescription.
Currently, the “period of supply” limit is three months in most cases, with six months available for contraceptivesor people travelling overseas.
Prime Minister Christopher Luxon thinks the idea has some merit. Taking talkback callers on Newstalk ZB’s Kerre Woodham Mornings last week, Luxon said: “I think there are things we could be doing to make regular prescriptions be extended for longer periods so you are not in front of a GP.”
Health Minister Simeon Brown told the Herald he was “seeking advice on a range of initiatives that will enable Kiwis to access the timely, quality primary healthcare they need. As the Prime Minister has said, this includes advice on repeat prescriptions”.
But the benefits of such a change would come at a cost, with the Royal College of General Practitioners warning that a 12-month extension to the period of supply would see a revenue loss to practices that would need to be made up elsewhere – and if it were not, some practices may close.
“To balance patient safety and GP practice sustainability, costs would need to be subsidised by introducing charges to patients,” the college warned in a submission on the idea written last October, specifying practices would “either need to charge more for other non-contact services, raise fees or cut services”.
Health Minister Simeon Brown. Photo / Alex Burton
Last year, the Ministry of Health opened consultation to extend the “period of supply limit” from three to 12 months. Under that proposal, the dispensing limit, which is the amount of medicine that could be collected at one time, would remain at three months.
This would mean, in practice, a single visit to a prescriber, either a doctor or a nurse prescriber, for a 12-month prescription, consisting of one initial round of medicine and three repeats.
Some restrictions would still apply in special cases.
The proposal cuts to the heart of several challenges in the health sector, including the cost to patients, GP wait times and GP practice sustainability.
Labour’s health spokeswoman Ayesha Verrall said it was “important to strike the right balance between convenience and lower cost as well as safety”.
Verrall said that while she supported measures to make healthcare more affordable and easy to access, these changes were not a silver bullet. She warned that it was not clear that the move “will have a positive impact in freeing up GPs’ time”, meaning more pressure on primary care from a funding and workload perspective.
Verrall also said it would be important for prescribers to “exercise judgment for people who needed more frequent reviews than the legislated maximum”.
The Royal New Zealand College of General Practitioners’ submission, written by the organisation’s medical director Luke Bradford, argued an extension was “potentially risky or dangerous for some patients. Regular reviews are crucial for monitoring patient health and adjusting treatments as needed”.
Bradford’s submission said the 12-month proposal was “considered unsafe for patients because it significantly increases risks for patients, specialist GPs and the health system”.
“Reducing clinical opportunities for care has inherent risks for clinical outcomes and access to poor-quality care increases the risk of worse outcomes. Reduced contacts for care will further compound health inequity for people with complex and challenging health problems.”
Labour health spokeswoman Ayesha Verrall. Photo / Mark Mitchell
“The 12-month option would significantly reduce opportunities for extended monitoring and continuity of care. It has the potential to increase adverse outcomes, substantially impact on people most at risk, and substantially affects the sustainability and viability of general practice,” Bradford wrote in a submission.
He wrote that the college supported extending the prescription limit to six months as a halfway point, but only for “medically stable patients”.
The college said an extension would have some positive effects, including “providing financial relief” and “reducing the frequency of GP visitors”.
“For specialist GPs, reducing the number of prescriptions may have a positive impact on the administrative burden and enable them to focus on patient care and other essential responsibilities,” Bradford wrote.
However, the changes come at a cost to practices that rely on patients coming in for repeats to maintain their revenue. One specialist GP told the college the 12-month proposal could mean a $320,000 loss in a patient population of 14,500.
Bradford told the Herald that for some practices, 7 percent of income came from prescriptions. Reducing that income could be “catastrophic”.
“It [the proposal] would work if you could say you’re taking work away and you would be supplementing it with more patients, but the work is still going to be there,” he said, noting that GPs would still be required to check in on patients’ wellbeing when on repeat prescriptions, without being funded for it.
He said it was important any changes “puts the discretion at the hands of clinicians”.
Thomas Coughlan is Deputy Political Editor and covers politics from Parliament. He has worked for the Herald since 2021 and has worked in the press gallery since 2018.
