Vouchers cut the wait for patients

By MARTIN JOHNSTON

Some emergency department patients facing long waits at public hospitals will be offered cut-price care in a bid to shift them to the private sector.

Auckland City Hospital intends introducing the voucher-based scheme this week, North Shore Hospital is considering a similar scheme, and the Starship children's hospital also plans to use vouchers.

During increasingly common busy spells at North Shore, once patients have an initial assessment from a nurse, they face waits of four to eight hours to be treated in the emergency care centre for non-urgent conditions.

Waitemata District Health Board chief executive Dwayne Crombie said that at these times such patients were encouraged to go to privately owned accident and medical clinics. Most went, but some could not afford the fees - up to $70 in the middle of the night for an adult without a community services card.

"We are debating whether we give these people vouchers when we are absolutely overflowing," Dr Crombie said. "Some people think that's a good idea; some think it undermines things."

North Shore commonly leaves emergency department patients on trolleys in corridors while they wait for admission to a ward.

The Auckland City Hospital and Starship voucher schemes are financed by the White Cross group of accident and medical clinics. White Cross is also paying for an advertising campaign urging people to see a GP promptly, to reduce the load on hospital emergency departments.

Staff in the adults' hospital will offer White Cross discount vouchers to some low-risk patients. Their value will vary. For adult medical consultations they offer $10 off normal fees.

The clinical director of the hospital's emergency department, Dr Peter Freeman, said his staff would offer the vouchers under strict conditions, to fewer than eight of the average of 150 patients coming through each day.

Only patients with straightforward minor needs would be offered vouchers, and even they could refuse and wait to be seen.

Vouchers would not be offered to patients with symptoms such as headaches that might be masking more serious conditions.

He said patients coming to his department when they could have gone to a GP added only slightly to the hospital's overcrowding. More important was the hospital's failure to discharge some patients promptly.

A White Cross general manager, Dr Robert Kofoed, said Starship had decided to offer the vouchers only once patients had been treated, "for use over the weekend where they might need to be reviewed by a doctor".

Health Minister Annette King this week endorsed the voucher scheme, although she said the decision was one for health boards to make, not her.

"It is their way of handling people who go to A and E when they ought to visit a GP. I think it is an innovative way of making sure people go to the right service at the right time."