The money the health system has to fight Covid-19 in the first half of 2023 is less than half of what it had in the second half of 2022, Marc Daalder reports
Staff on the Covid-19 response have been terminated or quietly reassigned to other health issues as funding to fight the pandemic dries up, Newsroom understands.
On the frontlines, this means vaccination and RAT distribution centres closing and call centre capacity shrinking, for example. Funding cuts began as early as mid-December, health workers say.
New guidelines issued by Te Whatu Ora/Health New Zealand which come into effect on Monday also reduce the funding GPs get for Covid-related care. Chart reviews will no longer be funded at all and doctors will get less than half of what they used to get for proactive clinical assessment – and only for high-risk patients. RATs conducted at a practice are only funded if they return a positive result.
The gap between central funding and practice’s expenses will have to be made up through charging patients for Covid-related care or from GPs’ pockets.
The changes come as the overall funding going into the health system to battle the virus in the first six months has been halved from the levels in the second half of 2022, which in turn were halved from the amount available in the first half of that year.
Nick Chamberlain, the national director of the National Public Health Service within Te Whatu Ora, said the “overall need for services is decreasing”.
“Firstly we would like to take this opportunity to thank everyone who has been involved in the response for the past three years. The response to the Covid-19 pandemic continues to be an important priority and is currently funded through till June 2023. Future decisions will be made in the coming months regarding continued funding,” he said.
“Overall, Manatū Hauora and Te Whatu Ora estimate the funding required for services supporting the Covid-19 response through until 30 June 2023 will be about $540 million. This is less than a quarter of the equivalent cost in the first half of 2022, and less than half of the cost for the second half of 2022.”
The funding can be cut because of economies of scale achieved through the DHB merger, the targeting of Covid-19 funding to those in greatest need and standing down services no longer needed like contact tracing and mass vaccination centres, he said.
However, health workers have expressed concern to Newsroom that the cuts go too far when the virus is still posing a serious threat to public health.
Covid-19 killed more people in the past three months than died on New Zealand’s roads in all of 2022, according to Ministry of Health data. On average over the first five weeks of 2023, more than 20 people died of the illness every week.
Primary care providers worry the addition of co-pays to Covid-related care could lead to cases not seeking help – or not testing in the first place. The sector is already underfunded, with a Government-commissioned report released last year showing GPs are making a loss of $29 per patient, on average.
Demand for Covid-19 care is also expected to increase as we move closer towards winter. Cases in the last wave peaked in the week before Christmas, with nearly 600 people in hospital and 46 deaths in that week. They’ve been dropping steadily ever since but are likely to rise going into autumn.
Those working within the Covid-19 response say the funding cuts will leave the system unprepared for future waves. Even basic logistical tasks, like arranging isolation accommodation for tourists who test positive or those who can’t isolate at home, are no longer staffed across large parts of the country, Newsroom understands.
Chamberlain didn’t answer specific questions about which services have been cut as a result of reduced funding. Decisions are made on a district-by-district basis, according to those on the frontline, so some services may be available in some regions but gone in others.
He did say the system could scale up again if needed.
“The health system retains the core services needed to manage Covid-19 and can scale these services up in response to an increased risk. However the gains made in responding to Covid-19 today means we are in position to free up more funding, and health workers to respond to other pressing health needs of communities across the motu and deliver better and more equitable health outcomes for New Zealanders,” he said.
Free RATs are still available via the Request a RAT website, though some of the pharmacies listed as distributing them are understood to no longer be participating in the programme.