GenPro cries foul over higher subsidies for virtual GP visits

NEWS - eHealthNews.nz editor Rebecca McBeth 

The General Practice Owners Assocation (GenPro) is concerned that the Health New Zealand | Te Whatu Ora Online GP Care service contract offers higher subsidies for virtual consultations than in-person casual GP visits, raising issues of fairness and potential impacts on patient care.

The organisation, which represents more than 475 general practices nationwide, supports the use of telehealth services but argues the contract structure creates unfair competition between virtual and in-person care.

Chief executive Mark Liddle says the contract for the new national telehealth service means that for some patients, the telehealth subsidy is up to five times higher than the equivalent General Medical Services payment for doctors seeing casual patients in-person.

Online GP Care, previously called the 24/7 digital health service, soft-launched in May with eight providers and fully launched in July 2025 with funding of $164 million over five years.

"You have to ask the question, why would the subsidy be that much higher for a service that cannot actually lay hands on a patient versus a practice sitting in person seeing patients?” asks Liddle.

Martin Hefford, director Living Well, Health New Zealand, says the subsidies paid to GP Online Care providers range from $2 for all patients, up to $75 for a child whose parent has a community services card, and the average capitation fees paid to general practice for enrolled patients are much higher than this.

“By providing a safe, subsidised option for casual or after-hours needs, the intention of the service is it also helps GPs keep their books open for enrolled patients who rely on them for ongoing care,” he says.

“Importantly, patients’ regular GPs will continue to receive their usual funding. Even if an enrolled patient chooses to use the Online GP Care service instead, their clinic keeps the same capitation payment.”

Liddle says telehealth works best as an enhancement to general practice services, particularly for patients who cannot physically visit their GP, rather than as a standalone service.

However, the contract requirements for GP Online Care favour large-scale providers, potentially discouraging smaller practices from offering telehealth services to their own patients.

"With this incentive comes the requirement to be able to offer this service to meet the service specifications, which is at scale, which means that a smaller provider who could have done this cannot meet the requirements," says Liddle.

He says estimates are that 20 to 25 percent of patients seen through telehealth services are referred to their regular GP because their condition cannot be addressed remotely.

"If 25 percent are being referred, then that is not alleviating the workload, it is just putting a step in before the patient presents at general practice anyway," he says.

The GP organisation wants to see outcome measurements rather than simple consultation counts to evaluate the online service's effectiveness.

Hefford says the organisation is working through the first set of data collected since the launch of Online GP Care. This includes pulling together an overview and undertaking analysis across a range of indicators, including demographics, reasons for use, appointment outcomes, times of access, and provider use.

“This work will give us valuable insights into how and when the service is being used, by who, and for what kinds of care. It will also help us understand where unmet need exists and how to further improve access and integration with general practice,” he tells eHealthNews.

Health NZ will release a summary of the information to the sector and public a month after launch, he says.

“The Government’s enhanced capitation funding, announced earlier this year, reflects the strong value placed on the enrolled GP relationship,” says Hefford. 

“And importantly, we’ ae not ruling anything out – we will continue to review the GP Online Care service fees and monitor the impact on both patient access and the sustainability of general practice.  The aim is to maintain continuity of care wherever possible, but also to provide options for people when their GP is not available.”

GenPro chair Angus Chambers says that while GenPro welcomed the recent increased funding for general practice, it is important to emphasise that this boost was only for enrolled patients. 

“This new telehealth service is for non-enrolled patients or those seeking care when their regular doctor cannot see them - which is a service many GPs also provide,” he says.

“This is an important distinction as the huge advantage for telehealth will significantly undermine the sustainability of general practice.”

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