Dunedin GPs are criticising the Southern Primary Health Organisation's proposed funding changes, saying it is offering to pay for procedures that come under the district health board, while leaving other patients in the lurch.
GPs and other interested parties have been consulted this month on the PHO's 2011-12 clinical programme.
Amity Health Centre GP Phil White said between 150 and 175 of the practice's patients receiving help for chronic conditions appeared not to qualify under new criteria focused on Maori, Pacific Islanders, and those living in the poorest areas.
The focus had switched from subsidising patients with a range of health conditions, towards targeting specific health issues, focused on "high needs" patients.
This meant a millionaire living in a deprived area of South Dunedin would qualify for some programmes while a very ill person living in a wealthier area could miss out, Dr White said.
The PHO seemed to have wandered into areas of district health board care, such as colonoscopy and CT colonography, which are used to diagnose cancer.
"While we aren't against improvements in access [to diagnostic procedures] we feel it should come from secondary care [budgets].
Mr White said the super PHO that formed in October from nine Otago and Southland entities seemed to be struggling to provide consistency across the region and had fallen back on ethnicity and socioeconomic data instead of "innovative" solutions.
His views reflected those of his three GP colleagues at Amity, he said.
Mornington Health Centre manager Barbara Bridger said the PHO appeared to be trying to dig the health board out of its deficit by funding procedures like colonoscopy.
Ms Bridger opposed changes in the way money for chronic conditions would be distributed, saying it focused on short-term treatment rather than managing conditions.
Mornington's submission to the PHO, co-signed by GPs Dr Tony Fitchett and Dr John Greaves, says if the PHO went ahead and "siphoned" money off to health board services it was unfair to Otago and Southland people.
SPHO chairman Dr Conway Powell said there were some "desperately crook" people who needed immediate help.
Of colonoscopies, funding would be focused on patients in Otago where access to the procedure was worse than Southland. In Southland, males requiring lung X-rays would be prioritised. The PHO would use both the public and private sectors.
The PHO had just $13-$14 per patient in discretionary health programme spending to dole out, he said.
Southern District Health Board funding and finance general manager Robert Mackway-Jones said the health board would talk to the PHO about its proposals.
