Greetings from New Zealand... Dr Annabelle Mascott of Woolwell Medical Centre compares GP practice in New Zealand with ours in the UK
I
am currently taking a brief sabbatical and enjoying a working holiday in New Zealand. I thought it might be interesting to compare our own health service with that in New Zealand - how much it is the same, where it differs and what insights that gives us on our own position. GPs in New Zealand experience a very similar training to our own. Once qualified, young doctors in both countries do a number of hospital posts to gain experience in different specialities and then have a period of training in General Practice before taking exams and qualifying as GPs. Like in the UK, most GP practices are still owned by groups of partners, many of whom own the premises where they work as well. The partnerships then have a contract with the health service to provide medical services and get paid for the services they provide. Both countries pay a basic amount per patient (capitation payments) and then fees for different targets and extra services. The GPs use this money to run the surgeries. In contrast to the UK, the NZ health service is not free at the point of need. Patients in General Practice in NZ pay a contribution to the cost of a consultation when
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they attend, varying from about ÂŁ10-20 per visit to the surgery. Consultations are free to most children and to some patients with a high number of medical conditions. There is a higher charge if you are not usually registered with the practice. Home visits in New Zealand are very expensive and are rarely requested, although GPs there do visit nursing homes and patients with palliative and end of life needs. Like in the UK, there is a small charge for prescriptions but the number of medications available in New Zealand is much more limited and they have a very strict list of medications that can be issued on prescription. As they are a small country of only four million people, their government has limited funds to spend on medicines and therefore negotiates with drug companies to enable a preferred supply of one or two options for each sort of medication. GPs here are encouraged to stick to a list of regulated medicines but have a much wider choice and less restrictions. When I am working in New Zealand, I work mostly in rural practice. Like in the UK, rural GPs tend to provide more care than in urban areas where other facilities are
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