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Speaker 1: Right, more angst than the medical field. This time at

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Speaker 1: your GP, claimers appointments could as soon cost if they

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Speaker 1: don't already sixty five bucks. I think they're sixty five

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Speaker 1: bucks at my place anyway. Health New Zealand's only increasing

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Speaker 1: funding of general practices by four percent. General Practice Chair

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Speaker 1: Brian Betting's back. Well this Brian, very good morning to you.

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Speaker 2: Good morning Michael.

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Speaker 1: Are we're in a rutt yer. It's not like I mean,

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Speaker 1: we seem to be talking about the same thing all

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Speaker 1: the time. Not that I don't like talking to you,

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Speaker 1: because you're a nice bloke, but I mean we seem

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Speaker 1: to be saying the same thing. It's too expensive, too expensive,

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Speaker 1: too expensive? Are we stuck? Yeah?

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Speaker 2: Look, the actual underlying problem is over the last ten

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Speaker 2: years there's been an underlying funding shortfall that's developed. So

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Speaker 2: over a year, if you pay one to two percent

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Speaker 2: less than the cost of providing service, over ten years,

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Speaker 2: that becomes ten to twenty percent. So at the moment

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Speaker 2: we estimate that underlying shortage is about fourteen percent, to

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Speaker 2: the point that some practices are now not viable. We've

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Speaker 2: seen that in the Macargill South Taranaki. We've recently seen

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Speaker 2: it apart. We've got a real, real problem here with

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Speaker 2: the funding model and what's going on, and we're into

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Speaker 2: this problem every year.

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Speaker 1: Now, is it the model or is it just money?

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Speaker 1: You could remodel it till you blew in the face.

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Speaker 1: Unless the appropriate amount of money is there, it doesn't

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Speaker 1: matter what your model is.

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Speaker 2: The main funding mechanism is something called capitation, the fee

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Speaker 2: the government gives per patient that is signed up for

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Speaker 2: a practice. The funding model and the way that is

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Speaker 2: structured is not for purpose. It was designed twenty years ago.

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Speaker 2: It does not cope with what we do now today

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Speaker 2: that the world has shifted, and this absolutely urgently needs

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Speaker 2: to be reviewed in restructured, absolutely fundable.

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Speaker 1: But does that accepted Brian by the people who give

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Speaker 1: you the money or do they say no? In other words,

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Speaker 1: are they not giving you money because the haven't got

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Speaker 1: any money or they just think you're wrong.

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Speaker 2: Interestingly enough, the government commissioned to report two years ago

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Speaker 2: in twenty twenty two called the Sapere Report, which identified

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Speaker 2: the capitation model was flawed. They identified the underline funding deficit.

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Speaker 2: And this is an independent report commissioned by the government

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Speaker 2: and they have acknowledged that report and said we have

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Speaker 2: to fix this. We've obviously run into the problem this

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Speaker 2: year where they said there's no money to do that,

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Speaker 2: but we've had assurances off the government and the Minister

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Speaker 2: that next year twenty five twenty six, the underlying formula

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Speaker 2: will be hopefully, Thanksed Goose, well.

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Speaker 1: Let's hope so, and then we can talk more positively. Brian,

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Speaker 1: you have a good week. I appreciate it, Brian, Betty

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Speaker 1: the General Practice chair. Then you get to the question

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Speaker 1: if your doctor does get to be sixty five dollars?

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Speaker 1: Is sixty five dollars for what you're getting. Think about

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Speaker 1: it for a moment. This is a seasoned professional with

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Speaker 1: advice you can't even dream of at sixty five dollars?

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Speaker 1: Is that unreasonable?

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Speaker 2: For more from the Mic Asking Breakfast, listen live to

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Speaker 2: news talks that'd be from six am weekdays, or follow

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Speaker 2: the podcast on iHeartRadio.