Budget 2024: hospital boost but meds funding ‘in crisis’

On the surface, Budget 2024’s $2.12bn for primary care and public health over the next four years sounds impressive, said Bindi Norwell, chief executive of ProCare, a cooperative supporting 850,000 of the country’s healthcare professionals. But that’s roughly $530m per annum and it’s not just for primary care, she said. “It’s shared across mental health, community providers, ambulance services and aged care… which means that figure is spread extremely thin.” Natural population growth and our ageing population will soak up most of that $530m because of the way our health contracts are written, she said. “This doesn’t make the financial pressures primary care is facing go away. Nor does it address the fact that workforce costs and other inflationary pressures continue to outpace the funding practices are receiving.”

It is a step in the right direction, said Royal New Zealand College of General Practitioners president and Wellington GP Dr Samantha Murton. “But it is disappointing to once again see the biggest slice of funding going to hospital services, instead of being reprioritised into primary care. You cannot prevent someone from being hospitalised once they are already in hospital – it needs to be prevented in the community and in primary care.”

As part of the Budget, the government said it was also “prepared to make fair and reasonable contributions to supporting non-government healthcare providers to deliver ongoing services” but would not commit to specific funding amounts in advance of settlements being reached. Norwell welcomed the news, saying that while primary care practices are extremely supportive of paying their nurses more money, the reality is that they cannot afford to carry these costs without additional funding. “It is imperative that the government takes this into account,” she said.

Health Informatics New Zealand confirmed more than $330m originally earmarked for data and digital health initiatives at Te Whatu Ora over the next four to five years will be returned to the Treasury. The ‘unspent’ money was identified as part of savings initiatives.

As well as any mention of eyecare being absent in Budget 2024, so were Māori, said Te Pati Māori co-leader Debbie Ngarewa-Packer, who called it ‘‘a privileged budget’’. ‘‘There is not any eye on Māori – you can’t even see the word. It’s like we don’t exist and we’re seeing the dismantling of kaupapa that actually fought for Māori solutions. Whānau Ora has got the best social return on investment, but it has absolutely no increase in funding. Why?”