July 2002 issue Pharmacy Today magazine

PATIENT DRIFT

Some community pharmacies could be in for a rough ride as Primary Health Organisations (PHOs) begin to emerge.

Patient drift is expected because the cost of primary health services could vary significantly from area to area, depending if a PHO's patients are poor, Maori or Pacific Island.

Doctors, in particular, are worried wealthier patients will travel to areas with a higher level of low-income patients, to take advantage of the lower charges.

At a recent Ministry of Health hosted conference on primary health, one doctor claimed he had lost 450 high needs patients to a neighbouring Maori health provider offering cheaper care.

In response to questions from Pharmacy Today, the Health Minister's office said patient charges for pharmaceuticals will be reduced with the priority being high needs groups.

Details on how this will be implemented have yet to be released.

Pharmacy Guild chief executive Murray Burns says how such a movement of patients will affect patient access to services, or impact on community pharmacy, is yet unknown.

"But the government has to be concerned at the fiscal risk that could be created if the market gets distorted, and whether cheaper services are in fact reaching the right people."

Under current ministry plans, PHOs will have to prove to their District Health Boards that at least half their enrolled population is Maori, Pacific Island or of high need to receive higher funding.

But all patients registered will get the same level of subsidy regardless of whether they are within the target group.

Funding for "low cost" primary health services for all New Zealanders will be in place in 8-10 years, according to the ministry.

Pharmaceutical Society president Bernie McKone notes that pharmacy has become adept at adapting to a dramatically changing market.

"My initial thoughts are this is a new market force that could cause doctors to close or patients to pick up scripts from other pharmacies."

"It's early but I expect pharmacy to respond to the changes in ways such as strengthening patient loyalty through better services."

At the recent Primary Focus conference, New Zealand Medical Association chairman Dr John Adams voiced concerns that the Primary Health Care Strategy will kill off many general practices.

The ministry's Primary Health Care strategy manager Kathy Spencer said any targeting system has imperfections as seen in the poor uptake of the Community Services Card.

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