Prevalence and Consequences of Barriers to seeing a GP for children
Primary health care provides essential preventative, diagnostic and treatment services to the population. However, inequities in accessing primary health care contribute to poor health outcomes and health inequities. While children under 14 have been eligible for free GP visits in Aotearoa New Zealand since 2015, barriers remain that disproportionately affect Māori and Pacific children. This research, led by Dr Mona Jeffreys, used data from 5,947 children in the Growing Up in New Zealand cohort to examine barriers to seeing a GP, the consequences of these barriers, and outline some policy actions that could reduce inequalities in access.
Findings
Overall, 4.7% of children experienced barriers to seeing a GP at age 12 months to 24 months, as reported by their mother or caregiver. More Māori (8.3%) and Pacific (7.0%) children, compared to NZ European children (2.8%), experienced these barriers.
Common barriers to seeing a GP across all of the children in the cohort included:
- unable to get an appointment
- after hours
- not having transport
- not being able to spare the time
- cost
- not able to get in touch with a GP; and
- not having childcare
Maori and Pacific children who face barriers to primary care were twice as likely to end up in hospital that those who do not face barriers. Despite the zero-fees policy, some caregivers report not taking their children to see a GP due to cost. This may refer to the perceived cost of a GP appointment, refer to the cost of transport, cost of time off work, childcare for other children in the family or could be due to children not being enrolled in a practice, so not being eligible for free visits.
The researchers say this study reflects the disproportionate experience of barriers to seeing a GP among Māori and Pacific children, and highlights the inequity in the provision of primary health care in Aotearoa New Zealand. The researchers suggest policy makers consider how to reduce barriers to primary health care and reduce hospital admissions among children by prioritising improved access to GPs for Māori and Pacific people, promoting children’s’ eligibility for free GP visits, carefully considering the locations of primary care services, and ensuring future health policies align with contemporary interpretations of Te Tiriti o Waitangi.
