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Fees in NZ

Discussion in 'New Zealand' started by Mark Dave Smith, Aug 1, 2012.

?

Why are APC fees so high?

  1. Small professional body

    6 vote(s)
    50.0%
  2. Not enough members

    6 vote(s)
    50.0%
  3. High amount of disciplinarys

    0 vote(s)
    0.0%
  4. High amounts paid to disciplinary panel members

    0 vote(s)
    0.0%
  5. Podiatric surgeons increasing costs

    1 vote(s)
    8.3%
  6. High running costs of the Board

    2 vote(s)
    16.7%
Multiple votes are allowed.
  1. Mark Dave Smith

    Mark Dave Smith Active Member


    Members do not see these Ads. Sign Up.
    I would welcome some comments on the following:

    I hypothesise APC fees are high because:

    1. The board is a small organisation with few members.
    2. We as a profession have a high amount of complaints against us.
    3. We are subsidising podiatric surgeons.
    4. 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?

    Comments please.
     
  2. Greg Fyfe

    Greg Fyfe Active Member

    I don't think I can accurately answer your poll.

    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
     
  3. Mark Dave Smith

    Mark Dave Smith Active Member

    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.
     
  4. Greg Fyfe

    Greg Fyfe Active Member

    Hi Mark

    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

    If you haven't done so already I'd suggest having a read around the website. Especially this link

    http://www.podiatristsboard.org.nz/Site/Publications_and_News/publicationsnews.aspx

    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.

    also functions of the board

    http://www.podiatristsboard.org.nz/Site/about/Functions_of_the_Board.aspx

    and on the Ministry of Health website, there sprobably quite a bit but heres a link to get you started

    http://www.health.govt.nz/our-work/regulation-health-and-disability-system/health-practitioners-competence-assurance-act


    I don't know what Podatry NZ offer, other than what you can read on their website, sounds like you get well served by the UK one.

    Kind Regards
    Greg
     
  5. Mark Dave Smith

    Mark Dave Smith Active Member

    Thanks for taking the time Greg, your a gentleman.

    Regards,
    Mark.
     
  6. Steve York

    Steve York Member

    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!
     
  7. Steve York

    Steve York Member

    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.
     

    Attached Files:

  8. Greg Fyfe

    Greg Fyfe Active Member

    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
     

    Attached Files:

    Last edited: Aug 7, 2012
  9. Greg Fyfe

    Greg Fyfe Active Member

    Thought I'd try a different layout

    Nurses 40,616 APC's at $110 ( incl disp’ levy) est Board Income p.a. $4,467,760

    Dentists 2000 APC's at $ 759.82 incl disp’ levy est Board Income p.a. $1,519,640

    Occupational Therapists 1770 APC's at $546 est Board Income p.a. $966,420
    ( at 2004)

    Optometrists 850 APC's at $ 735 est Board Income p.a. $624,750

    Chiropractors 430 APC's at $1124 est Board Income p.a. $ 483,320

    Podiatrists NZ 313 APC's at $817 est Board Income p.a. $ 255,721

    Podiatrists Au (2011) 3439 APC's at 368 ( $Au) est Board Income p.a. ($Au) 1,265,552
     
  10. Greg Fyfe

    Greg Fyfe Active Member

    upcoming review of HPCAA relavant Re: Fees in NZ

    Below from Allied Health Professional Associations will be of interest

    " likely that the scope of the review has been expanded to include changes to the Regulatory Authorities"

    This review process maybe worth following and possibly the opportunity to be consulted and conribute too.

    http://alliedhealth.org.nz/index.php?mact=News,cntnt01,detail,0&cntnt01articleid=14&cntnt01returnid=65

     
    Last edited: Aug 8, 2012
  11. Mark Dave Smith

    Mark Dave Smith Active Member

    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.
     
  12. AGHawk

    AGHawk Welcome New Poster

    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?
     
  13. Mark Dave Smith

    Mark Dave Smith Active Member

    And are we already carrying the can for another group of podiatry specialists?
     
  14. Greg Fyfe

    Greg Fyfe Active Member

    Below from the Health Workforce website dated 09/08/2012

    Sounds like the opportunity to put your concerns in front of the folk who make the policy and

    legislation ,that Podiatrists ( and the Boards) live within, is coming soon.



    http://www.healthworkforce.govt.nz/...h-practitioners-competence-assurance-act-2003

    Nb I think if you are making a submission as an individual you will need to specifcally state
    that within the submission.

    Regards

    Greg
     
  15. Mark Dave Smith

    Mark Dave Smith Active Member

    Thanks for that Greg, I have sent an enquiry.
    :drinks
     
  16. Greg Fyfe

    Greg Fyfe Active Member

    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

    as attached or link to;


    http://www.health.govt.nz/publication/review-health-practitioners-competence-assurance-act-2003-report-minister-health-director-general

    Interesting stuff on page 27


    Also Page 49, a reccomendation which would require a change in legislation before it could be applied


    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?

    Regards

    Greg
     

    Attached Files:

  17. katenz

    katenz Member

    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!
     
  18. Mark Dave Smith

    Mark Dave Smith Active Member

    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.
     
  19. Dragonette

    Dragonette Welcome New Poster

    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.
     
  20. simonf

    simonf Active Member

    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
     
  21. Mark Dave Smith

    Mark Dave Smith Active Member

    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.
     
  22. simonf

    simonf Active Member

    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):empathy:
     
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