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Fees in NZ
View Poll Results: Why are APC fees so high?
Small professional body
6
50.00%
Not enough members
6
50.00%
High amount of disciplinarys
0
0%
High amounts paid to disciplinary panel members
0
0%
Podiatric surgeons increasing costs
1
8.33%
High running costs of the Board
2
16.67%
Multiple Choice Poll. Voters: 12. You may not vote on this poll
The board is a small organisation with few members.
We as a profession have a high amount of complaints against us.
We are subsidising podiatric surgeons.
The board has to pay large fees to members to sit on disciplinary panels.
As a UK qualified podiatrist I find the professional fees over here exorbitant and cannot see why, what do I get for my $920 APC? Certainly not any form of indemnity insurance. Membership of the Society of Chiropodists and Podiatrists in the UK is £355 ($710) and includes indemnity. HPC membership also mandatory is around £160 ($320). Add membership to Pod NZ for your insurance =$2000+.
I am unhappy at the prospect of ever increasing fees and would like to see where the money is actually going.
Why does a registered nurse pay around $90 a year for their APC and yet is legally allowed to provide podiatry services?
If the fees we pay are just going towards running costs, then is it time for our board to be merged with other professional bodies?
I have no idea if disciplinary panel representatives get paid, if we have a high number of disciplinaries, or if the board running costs are high.
I don't think the poll will provide an informed result other than "popular" opinion.
My understanding is that legislation determines registration boards can only be self funded by the professionals registered to it. So I presume a small professional group means we pay more per person to our board than nursing for example.
If I recall correctly the Board has at least once worked with other smaller registration boards to share overheads and improve economies of scale
What do you get for your APC? the legislated right to use the title "Podiatrist" and earn an income from that. You also get to claim it as a tax deductable business expense.
If your in private practice you recover your APC from client fees ?
Perhaps the question is what does the Public get for your APC, which is some assurance that the Podiatrist they're seeing is "safe'.
The Podiatry Boards role is primarily to look after the public interest within the bounds of the relavant legislation of the day.
With respect to insurance, I think you can get that without being a member of Pod NZ. It's not the Boards responsibilty to provide insurance, as far as I know they don't elsewhere.
I think the Board also produce, and send to APC holders, an annual statement/report including a financial report which will give you some idea as to how funds are expended.
I don't know if it's in the bounds of current legislation but maybe we could take a tip from the current governments charter schools intitiative and look to seek commercial sponsorship for board funding
Regards
Greg
The Following User Says Thank You to Greg Fyfe For This Useful Post:
Hi Greg,
Thanks for the reply. As outsiders my wife and I have found professional registration information hard to come by and feel fustrated. Forking out $$$ to sit 50 multiple choice questions on cultural awareness that a 6 year old child could pass, didn't help my mood either. Neither did my wife having to pay $420 for 2 weeks APC mid March. Yes fees can be reclaimed, but I don't like to see yearly increases of over 10% or hear how much money the board have paid out to fly people into Wellington.
Having only registered last year from the UK, I'm a little in the dark about the role of the board as my only encounters with them has been requests for money. Other than an APC cert I have not been privy to where our money goes.
Am I correct to assume:
The boards role is to protect the public, ensuring that podiatrists are properly qualified, have up to date CPD and administer any disciplinary actions?
I personally haven't joined Podiatry NZ as I have overseas membership from the UK, which covers my indemnity insurance. Included in this I receive a monthly magazine and a journal. The society also has a members area with online CPD and a good public side to the site. Would I get similar from NZ podiatry?
Please forgive me my naivety, but I feel very much an outsider the workings of our professional bodies over here.
It's a pretty big step to move countries, even if your coming to an English speaking one. I'm not suprised you feel on the outside. I think the consensus is that it takes about 2 years to setlle in even if you just move towns.
In response to your query about the boards role ,from the Boards Homepage
Quote:
The Board operates under the Health Practitioners Competence Assurance Act 2003 and is the regulatory body for the occupation of podiatry (and chiropody) in New Zealand. The Board's primary role is to protect the public interest by ensuring that podiatrists are safe and competent to practice.
If you haven't done so already I'd suggest having a read around the website. Especially this link
Theres some links to Newsletters and Annual Reports which could give you some background to the mysteries of the Podiatry Board, they go back a few years and you can claim the reading for CPD ( I think)
The current HPCA act which mandated CPD was passed in 2003 and CPD came in around 2005. A bit of reading around the Act might be worthwhile.
Forking out $$$ to sit 50 multiple choice questions on cultural awareness that a 6 year old child could pass, didn't help my mood either.
Having a 50 multichoice questionaire on cultural awareness that a 6 year old child could pass, is not likely to make someone culturally competent either or let alone put a person in a good mood to want to be!
This is not likely to help your mood either. This is a comparison of fees for annual practicing certificates, association fees, indemnity insurance and conference fees for different allied health professions in NZ in 2012.
The Podiatry NZ AGM is on Thursday 13th September at 4.45pm at the Aotea Centre after the first day of the conference. You may want to table your concerns onto the agenda prior to attending, so that you can address these matters in the most appropriate forum as both Podiatrists Registration Board members and the PNZ executive will be in attendance. You may receive a response that may substantiate such costs and variances between professions and I'm sure you will have a captive audience.
The Following 2 Users Say Thank You to Steve York For This Useful Post:
Interesting table Steve, I haven't been able to get a table format into this post, so have attached it as despite lining up the figures it doesnt seem to come out that way.
Taking workforce survey data mostly from around 2009 I put together the below figures. There seems to be a relationship between smaller professional groups and higher APC's.
I guess theres a threshold where the number of APC's starts to achieve an economy of scale. Somewhere before 40,000 APC's I guess
I don't know how the Australians do it but they have approx 10x the podiatrists we do yet their Board appears to manage on an income that is 5-6 x ours rather than 10x which you might expect from the numbers. Perhaps the economy of scale occurs below 3439?
Group Number of APC’s APC Cost Estimated Income from APC’s
Nurses 40,616 110 ( incl disp’ levy 4,467,760
Dentists 2000 759.82 incl disp’ levy 1,519,640
Occupational Therapists 1770
( at 2004) 546 966,420
Optometrists 850 735 624,750
Chiropractors 430 1124 483,320
Podiatrists NZ 313 817 255,721
Podiatrists Au (2011) 3439 368 ( $Au) ($Au) 1,265,552
Regards
Greg
Last edited by Greg Fyfe : 7th August 2012 at 05:39 AM.
Reason: sentence structure
May 2012 newsletter
Health practitioners have long been awaiting news about the upcoming review of the Health Practitioners Competence Assurance Act 2003. The terms of reference are, we understand, going through a Cabinet process and it is likely that the scope of the review has been expanded to include changes to the Regulatory Authorities. Professor Des Gorman, Executive Chair of the Health Workforce New Zealand (HWNZ) Board, was recently quoted as saying: “Our work programme includes the proposal for an amalgamation of support functions for the regulatory authorities (RAs) to extend the focus of the RAs from 'patient safety' alone to 'patient safety, workforce intelligence gathering and workforce husbandry'. A reform of this nature in Australia has proven highly successful.” This provides another indication of the changes which are proposed. AHPAF, along with other health practitioner bodies, is keen to see the full extent of the proposals so that they can be examined in detail. We will keep you posted.
Antony McFelin
Chairperson, AHPAF
Shani Naylor
Executive Director
Last edited by Greg Fyfe : 7th August 2012 at 06:42 PM.
Reason: added quote
As I am not a member of Podiatry NZ I don't have an invite to the back slapping party in Auckland. I'm afraid that as far as professional registration goes, I believe beaurocrats will continue to dream up more exciting ways to take our money. Rising profesional fees will be eventually passed onto to our patients, who are already under enough financial pressure.
I've only been in this country 8 months and working for 4, but I've seen the damage well intentioned nurses are doing with unsterilised instruments and wish to keep my customers from their clutches.
If nurses are able to provide podiatry at knock down prices, they should be held to the same standards and financial .38 special we have to our heads. $35 is the going rate round here for giving blood through your toe ends and now I understand how others can afford to be so cheap.
Hi Mark,
I'm glad I'm not the only one who struggles with the APC fee and indeed its justification. Not being self-employed I don't have the ability to offset it as a business expense. I have long thought that podiatrists simply don't have the numbers to justify a separate board. I would propose that we have representation under an umbrella allied health board which may give us a stronger voice in legislative changes and recognition.
Aside from this I have concerns about prescribing rights and I would like to know how underwriters propose to deal with the increased risk exposure from prescribing errors. Will all podiatrists be asked to pay increased insurance fees or just those who choose to take up prescribing?
The Ministry of Health is about to lead a review of the Health Practitioners Competence Assurance Act 2003.
The scope of this review has been agreed by Cabinet and will ensure the Act retains the ability to safeguard health practitioners’ competence; but in a way that supports the delivery of the workforce required both now and for the future.
The proposed scope for the Review will assess how:
a. the Act supports the delivery of the workforce required both now and for the future
b. the pastoral care of the health and welfare of health professionals to support the sustainability of the workforce can be improved
c. a robust data collection system to inform sector intelligence and planning can be developed
d. the Act can work effectively within the wider health environment and whether the purpose of the Act remains fit for purpose
e. the health occupational regulatory settings can be improved
f. the Act can provide optimal levels and types of regulation for the next five to ten years
g. the operational functioning of the Act can be improved.
A staged approach will be taken to the Review, including a full public consultation. Work is underway on finalising the Discussion Document.
A copy of the document, the date of the consultation period and details on how to provide input into the review will be available here shortly.
We look forward to receiving feedback from a wide range of stakeholders, including health sector professionals, other interested parties and those who receive health care in our communities.
Nb I think if you are making a submission as an individual you will need to specifcally state
that within the submission.
Regards
Greg
The Following User Says Thank You to Greg Fyfe For This Useful Post:
Report Tabled in Parliament in 2009
If folk feel inspired , a read through this report could be informative. Particularly if thinking of contributing to submissions on the upcoming review
Review of the Health Practitioners Competence Assurance Act 2003: Report to the Minister of Health by the Director-General of Health
In its submission to the review, District Health Boards New Zealand said:
‘The unification of regulated occupational groups under a single piece of
legislation is viewed as strongly positive ... in terms of its potential to enhance the
flexibility of the health workforce. There is some concern that this potential of the
Act may not be realised due to the number of responsible authorities and the lack
of requirement for them to work together.’
Costs of regulation
Costs for responsible authorities are significant, and impose a cost on practitioners
through registration fees and disciplinary levies. Such costs are part of doing business,
and are passed on to the public and to employers. As such, they can affect fees or the
cost of providing services.
The costs of running an authority vary considerably, particularly in matters such as the
number of complaints to be investigated, the need to establish competence reviews,
and the approach to re-accreditation and assessment of overseas-trained practitioners.
One study,15 based on financial information from most of the authorities, gives an
indication of the main areas of expenditure and their relative size:
• secretariat costs 44%
• infrastructure 31%
• quality assurance costs 14%
• governance costs 11%.
This analysis shows that governance costs are only a small part of the costs of running
an authority. The most important measure in terms of managing costs is to ensure that
authorities collaborate and share administrative and secretarial costs.
Another report looked at the level of annual practising fees compared with the number
of registrants in various responsible authorities. Table 1 below shows that comparison
for six professions in 2003/04 and 2006/07. It is clear that costs are higher for smaller
professions.
15 Information supplied by 12 responsible authorities, May 2008, and reported by: D Hyland. 2008.
Review of Financial Statements of Responsible Authorities. Wellington: Ministry of Health.
Also Page 49, a reccomendation which would require a change in legislation before it could be applied
Quote:
Recommendation 18: That section 114 of the Health Practitioners Competence
Assurance Act 2003 be amended to give the Minister the power by Order in Council
to join and restructure two or more existing authorities and/or add other practitioner
groups to an existing authority in situations where, after consultation, the Minister is
satisfied that it is in the public interest to do so and the authorities and their
professions are generally in agreement.
I don't know what happened after this report was tabled. Possibly changes in Governments sidelined the reccomendations from progressing into active law/policy.
Perhaps there's someone out there who can tell us?
unfortunately this is part of the reason as new grad i left to work in australia.
$800 is more than an average weeks pay in NZ as a podiatrist.
yet in australia $350 wasnt a lot to fork out.
the people at podiatry NZ are lovely they have been great help in aplying for registration in australia and now the UK.
but $800 is a lot of money in NZ.
association fees were another story. if my employer didnt offer to pay them there would be no way i could have been a member. but as the NZ podiatry profession is so small everyone needs to band together to share knowledge etc.
maybe in terms of APC it maybe beneficial to create a HPC or APHRA like the Uk and Australia and have greater access to insurance and legal support.
but from personal experience with national health registration boards please if that happens keep all the staff on at Podiatry NZ as dealing with merged national registration boards they keep losing documents and take forever to answer your questions!
Thanks for your reply Kate. You have summed up my feelings as somebody who has just entered the profession in NZ. High fees can up to a point be absorbed by a private practitioner with a good client base and turnover, but as somebody setting up a new practise or an employee paying their own fees are badly disadvantaged.
Sadly it is our customers who will have the higher fees and ever increasing standards/regulations passed onto them, forcing people to seek cheaper gold coin alternatives.
The addressing of maintaining the profession in NZ is loosely addressed in the consultation document. (submissions close 26th October) This should be the opportunity to let the health care cost managers know in pounds shillings and dollars how underused, underpaid and undervalued we are in NZ, if the migration figures don't tell them some of that? Inequality of access to podiatry services for chronically ill citizens of New Zealand, and with the aging demographic, many who have already invested their tax dollars, have no access through public health to help to enable comfortable walking, a fundamental for the feeling of well-being and the ability to thrive. This profession can save DHB's hundreds of thousands of dollars by preventing the need for hospitalisations for wound treatments and limb amputations, which brings a whole other set of social, medical and human costs. Is this the opportunity to get Podiatry into its proper role of PRIMARY Care in the Public Sector, we can be part of the proposed MDT but only if we are appropriately funded like other primary carers, welcomed into the public health sector and this would then enable the 300 or so podiatrists registered in NZ to deliver what we were all trained for - at a subsidised cost affordable to the patient, and hopefully pay us suitably for our labours.
I personally haven't joined Podiatry NZ as I have overseas membership from the UK, which covers my indemnity insurance. Included in this I receive a monthly magazine and a journal. The society also has a members area with online CPD and a good public side to the site. Would I get similar from NZ podiatry?
Mark, are you saying that your SCP insurance is covering your practice overseas?
I thought they had stopped that a few years ago - I wasnt cpvered whilst in canada
I spoke to the SOCAP membership officer and the chair back in Feb and June this year and they confirmed I was covered to work and receive my indemnity in NZ as an overseas practising member. Otherwise they will be receiving a unpleasant letter.
I spoke to the SOCAP membership officer and the chair back in Feb and June this year and they confirmed I was covered to work and receive my indemnity in NZ as an overseas practising member. Otherwise they will be receiving a unpleasant letter.
I hope for your sake you are right. Have you got it in writing? Have you verified with your regulator that they are happy for you to have indemnity insurance based offshore. A previous SCP chairman told me they cancelled the overseas cover when he was in the chair.
Have you checked with the company provided in the insurance (cant remember who it is off hand) that they are happy to cover your current activity - they will certainly cover anything that might have been triggered by your previous UK activity, but you should ask the question directly for piece of mind. Lawsuits are very much more expensive than a years insurance cover.
When I was practicing in Canada, I ended up paying for UK insurance, to cover my previous UK work, and insurance in Canada (which was much more expensive than the UK, for similar reasons to your situation)
Fees in NZ
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