A long-awaited revision to funding for general practice in New Zealand has been introduced, marking the first substantial change to the capitation formula in more than two decades. The adjustments aim to better align funding with health needs by incorporating factors such as multimorbidity, rurality, and socioeconomic deprivation, though some stakeholders say the changes remain insufficient.

The capitation system, which allocates funding to general practices based on enrolled patients under Primary Health Organisations (PHOs), previously only accounted for age and sex. A 2022 report by consultancy Sapere, commissioned by the previous government, concluded that this narrow weighting failed to capture the true cost of delivering care, particularly in high-need populations. The report recommended including ethnicity, deprivation, and morbidity to provide a more accurate reflection of health needs.

Had the report’s recommendations been fully adopted, some practices with high-need patient bases would have required an increase in funding ranging from 34% to 231%, with a median increase of 10% to 20% for most practices. However, governments have been hesitant to commit to such substantial increases, citing budgetary constraints.

Health Minister Simeon Brown acknowledged the government provided the largest-ever funding boost to GP clinics last year and added an additional $120.6 million in this year’s package. While Brown emphasized that the new formula would especially benefit rural patients, some medical professionals remain critical of the scale and scope of the changes.

Dr. David McKay, a Dunedin GP and palliative care specialist, characterized the funding increases as falling short of covering rising costs, including those driven by inflation and increased patient complexity. He described the package as forcing practices to choose between inadequate options, and argued that it does not adequately support key areas of GP-led care such as palliative services.

Brown asserted that the majority of GP clinics supported the updated funding framework, but Dr. McKay suggested the support reflected limited alternatives rather than genuine endorsement. Notably, the new formula excludes an ethnicity weighting for Māori patients, despite Māori having a significantly lower life expectancy than non-Māori.

Some regional responses to the changes have also raised concerns. In Wānaka, local practitioners expressed confusion and apprehension about how rurality was classified and how this impacted funding allocations. Brown maintained that the reforms would better value patients in smaller rural communities, ensuring more equitable treatment compared to urban centers.

Separately, growing scrutiny surrounds the management of Ward 10a at Wakari Hospital, a secure 12-bed unit providing treatment and rehabilitation for adults with intellectual disabilities who are involved with the criminal justice system or present serious risks. Reports indicate patients were moved from the ward amid refurbishment plans, but Health New Zealand (Te Whatu Ora) has been criticized for a lack of transparency regarding the timing, reasons, and patient destinations.

The ombudsman reportedly raised serious concerns during visits to the unit in March and April, yet officials declined to provide clear information when questions were posed in June. Families of patients in both Ward 10a and the adjacent Ward 9a have expressed distress over the secrecy surrounding these developments.

Mental Health Minister Matt Doocey confirmed he had been briefed on allegations of patient mistreatment linked to the ward’s circumstances but has not publicly addressed the issue in detail. Observers are calling for greater openness and prompt investigation into the situation to alleviate ongoing uncertainty and trauma.