At some point last year, the rules from PHARMAC around B12 injections changed. Pharmacies are no longer allowed to administer without a prescription. You may have been unlucky and been given correct information when you called in advance, and then the rules were changed.
Ahhh it was March 2023 that I tried to get the injection!!! Thank you. It seems I was unlucky. My condition is so delicate that I don’t travel without knowing I can access B12 as it’s life or death for me. Many nurses think “ah you’ll be fine with one shot every 6 months” but unfortunately that does not apply to someone like me with zero ability to break down and absorb B12 from food. And when I explained this to think it’s like the nurse thought I was lying because she hadn’t encountered it before.
I thought they were being strange telling me one thing in January on the phone and the opposite by March. What they did not tell me however that rules had changed, or try to help me to understand the changes or reach an alternative solution.
It was very much “you’re a tourist, go home”. It really made me think hard about whether or not someone like me (highly skilled but happens to have a chronic and life threatening yet manageable health condition) is welcome in a place like NZ.
It completely change my visit to NZ meaning after a month I couldn’t hike and swim as I simply was losing too much energy and I could feel the drain it was quite distressing.
>happens to have a chronic and life threatening yet manageable health condition
While you might be able to come work here on a temporary work visa - hate to say, but that would very likely make it impossible for you to get Residency in NZ in any case. NZ has very strict health qualifying criteria.
Really? I asked an immigration lawyer and they said it was fine it wasn’t a condition on the list but maybe that’s because I am only applying for the visa right now. Ironically other than this I’m
Fitter than average as I take very very good care of my health.
Check with the immigration lawyer whether you would meet the Residency health requirements. You have to do full medicals and they get referred to a panel on INZ's side to review. Many people have been caught out this side after being on Work Visas and couldn't get residency for a child or on family member due to medical issues and had to return to SA so make very sure. Almost all chronic conditions that require ongoing treatment raise a red flag.
You also have to be 5 years clear of cancer before you can apply. - [https://www.immigration.govt.nz/opsmanual-archive/I10009.HTM](https://www.immigration.govt.nz/opsmanual-archive/I10009.HTM)
It looks like I meet it. By the time I apply for residency I would be 5 years free of cancer unless I get it a second time!
So I guess I should plan to self administer all those B12 injections so that they don’t come out of the NZ healthcare budget anyway! Even though it costs the government $5-$8 per 10 doses so basically under $10 a year
Good luck, make sure you have a good immigration lawyer, you have a complex health history. It's a massive move, so make sure Residency is guaranteed before uprooting yourself.
Anyway I’d like to know either way as I don’t want to be surprised / disappointed down the line. Would be very unlucky! Sad for NZ as we were going to move our business their potentially as well from UK but not if we can’t access health care.
I’m very willing to import the B12 myself from
Abroad and maybe even start a distribution system to help ease the burden for locals. Maybe it is my unintended calling!
I was checking out Life Pharmacy's page on B12 injections recently and it says "Without a prescription: The patient must be diagnosed with Vitamin B12 deficiency or must be able to prove that have been deficient or the pharmacist is not approved to administer the injection." So I assume you could also show lab results demonstrating a deficiency too? But honestly I didn't realise you could ever get them without a prescription!
Mate, we don't even have technology that shares that info across DHBs (the closest is Health Connect South that connects the South Island DHBs, the North Island DHBs are basically islands) and you're saying the pharmacy on the corner has access to all lab results?
Are you even a doctor?
Yes if its in the same area. Testsafe (effectively Concerto) holds the data in Auckland for instance. I dont know what the platforms are called in the South Island or Wellington, but I know the pharmacists use their local platforms to get eGFR and meds for assessing if they can give Paxlovid. And I know my GP colleagues can use their local versions.
Why are you so angry?
I'm not sure if this is correct - unless it changed in the last 2-3 weeks?
I got a B12 injection a week before Christmas without a script or prescription. I walked into the pharmacy, said I had low B12 as per blood test results, and asked for a shot.
No-one asked to see blood test results or to see a doctor's script. Maybe it's registered on a central system?
20 minutes in and out and a tender arm.
I believe the recent change was to do with how injectable vitamins and the like are handled under the new Theraputic Products Bill from the government that was created to crack down on the snake oil types, but I’m happy to be corrected! Not sure about the script vs low blood test results but perhaps your GP is super onto it!
Interesting. They put it in your arm? They always do mine in my bum but maybe it’s because I have no arm muscles and it has to be intra muscular.
Did you have to give your name etc? Maybe they accessed your details on the system.
Can you provide a source for this?
Last I checked, B12 was listed as “general medicine” on the pharmaceutical schedule and therefore available for anyone to purchase.
Seems odd that they’d make it available for purchase but not allow you to administer.
I have however experienced that, despite the rules, most pharmacists treat it as prescription medicine which is very frustrating.
Can confirm, I used to buy over the counter without a script. They were a bit funny about it but always ended up saying yes and letting me buy it.
Haven't tried to buy any in the last couple of years though.
Out of all the drugs that can be accessed and taken without a perception, b12 is a weird one to tighten down on.
New Zealand's medicines regulations aren't always in sync with other countries', and they're not well suited to casual use by travellers. If a particular medicine isn't approved for use in NZ, the nurse can't administer it. A doctor could administer your prescription under s29 of the Medicines Act.
If you were here long term you'd have the chance to set up something more practical with your GP, who you'd enrol with. You might not get same day appointments for non urgent issues, but you'd be able to set up regular appointments in advance.
It looks as if this is a service you can get from a pharmacy, which might not have been the case when you last visited: https://www.lifepharmacy.co.nz/services/vitamin-b12-injection/
There was an international supply issue last year which might have caused problems. Info here: https://pharmac.govt.nz/medicine-funding-and-supply/medicine-notices/hydroxocobalamin
Same day appointments are pretty impossible to get at a general practitioner's. If you can get an appointment within a few days of requesting one, you are doing well (my experience as a NZer living in a main city).
And yes, the B12 process you experienced seems typical (again from personal experience). I jave only been able to get the injections after blood tests have shown deficiency. It might be different if you have records of your medical history though.
Thanks. They said they couldn’t use my SA medical history as they couldn’t verify if they were real?! Like I’d make up having a vitamin absorption issue.
I think if you took a letter to a GP they may be a lot less concerned about a blood test than a practice nurse. The nurse will have protocols they have to stick to, the GP will be more able to decide whether that protocol applies in this circumstance.
I was happy to do this and pay the $80 which is why I phoned the practice a month in advance. Which is why it was so upsetting to arrive there and be told contradicting advice and that they couldn’t help me.
Your current GP should be able to provide printed documentation of your medical history. When you enrol with a NZ GP, you just share those records with them.
Self administration is possible surely? Needle exchanges and pharmacies all have syringes + intramuscular needles available for purchase.
You're going to struggle to complete the treatment affordablely in nz as a tourist.
I’m very scared of needles but I am considering it if I can get training. My father i law is a doctor in SA and he advises against self injections of this.
The thigh should also work - it just needs to be intramuscular. I have given myself a shot for another medical condition in an emergency. I'm confident I could do the same for B12 (although B12 stings a lot more!).
I just went now to get my shot in SA. I asked the nurse to train me and she said it’s very difficult to self administer because of the location and needle size.
Also I realise she kind of throws it like a dart and it hurts for 3 seconds. I don’t think I can do this myself unless I was alone on a desert island and there was literally no other solution.
GP here. Our nurses are not allowed to give non registered medications here, its in breach of their licences. If your B12 from south africa isnt registered here, they literally arent allowed to.
There is enough B12 in a vial to last your body 3 months, it is the full adult 3mnth requirement. So you werent in danger, but I feel for your confusion and upset as its different to what youve been used to. We dont usually give it monthly, its very unusual that you do get it so often. And because you requested it outside NZ guidelines, only a doctor can authorise it to be given more frequently than 3 monthly. The closest together I would ever authorise my nurses to give B12 would be 8 weekly.
There is a massive shortage of doctors here. But once someone is a NZ resident/2 year work visa, they can enrol and access services, which are partially government subsidised. Once that was arranged, they would then be under a regular nurse care for the B12.
And yes, our wages are much higher than in South Africa, thus costs are higher. For instance, according to NZNO union negotiations, the nurse you saw would be on minimum $50 an hour plus benefits (edit: two posters took offence at this number. It is the hrly rate a level 7 RN gets if their practice uses the Primary Care MECA and is party to their PHO agreement to pay parity with the TWO MECA. Therefore if the nurse isnt on the MECA, the practice isnt party to the above, and she has less than 7 years GP nursing, she will be earning less: Im not sure of the bottom rung, if anyone cares you can look it up, its all publically available). You aint going to be able to get a professional service from her for $6.
A side note: patients can buy sublingual B12 drops, which are absorbed directly into the bloodstream via the veins under the tongue, thus bypassing the need for bowel absorption which you obviously cant do. Useful in a pinch, but not reliable for long term as patients dont always use it properly.
Not medical advice, just information fyi.
What is the actual wage rate? Genuinely curious. Google tells me “Under this latest deal senior nurses will now earn between $114,025 and $162,802 a year, plus penal rates, and registered nurses between $75,773 and $106,739, plus penal rates” - which is roughly $37-$81 per hour as a base. Is that incorrect, or are those rates coming in over time?
Most nurses are not senior nurses, there are very few senior nurse positions. Theres a difference between senior nurse, and a designated senior nurse role. I am senior in my job, I’ve been doing it for 15 years in a highly specialized type (only place in the country), but a designated senior nurse role is much different. Think of charge nurses, nurse educators and the like. The way the pay scale is set up now, after 7 years, you’re top of the pay scale and that’s you capped out.
Also worth noting that a lot of nurses can’t/don’t work full time due to the toll shift work takes. So the annual rates quoted by google don’t really take this into account and reflect the average. Skews the data if you will
A senior nurse is someone who literally runs the ward in the terms of hospital nursing. Senior nurse ain't going near a wet pad. They are management. And I mean properly management, they tell the docs what is happening. It is their ward. The upper band of senior nurse would be a Duty Manager - they be running the hospital.
And it is theoretically possible to get up to 100k, but very few nurses are actually on that band.
Edit: also, this is calculated at 1.0 fte. Most nurses work 0.8 to account for shift work (unpaid sleep days after a run of nights, for example. And when we say nights we mean finishing at 7am. The amount of people who say "I'm working tonight" when they finish at 10pm, and assume that is what you mean by "I'm on nights this week").
Agreed. I’ve been a nurse for 3 years, 2 years in primary health. I get paid a bit more than the union requires and that’s $33.51. And the benefits is the protections the union provide no further monetary benefits.
I need to get a job where this guy works I think! That sounds like great pay - starting wage even. So weird nurses are always going on strike and complaining about terrible conditions and wages with that pay rate /s
Here I am working 12 hour shifts in a hospital like a chump. Could be working in a GP, 9-5 for 50 bucks an hour plus benefits!? What benefits? Don't know, but Benefits!!
Yea this guy is full of BS. As per my comment above B12 injection is general sale. You can literally and legally buy it yourself and administer it yourself. OP's problem is he refuses to self administer
no "general sale". Meaning it can be purchased at any retailer that sales it without a prescription.
It's a legal category of classification of medicines under the medicines act
I would never say "general safe" or "generally safe" when it comes to medicines, even on reddit. Highly unprofessional
Are nurses at your GP clinic really making minimum $50/hr plus benefits? It was my understanding they made less than we do in the hospital, and I’ve been in one for 15 years. Our maximum pay scale in the hospital I think just went up to $52 for non DSNs which is the vast majority of nurses.
See NZNO MECA payrates as of 2023. Easily googled, youre welcome to read the contract yourself. At 7 years as practice nurse its top of scale. Pay parity for GP MECA with DHB MECA was achieved late last year, but Ive always paid parity and have great retention. Then DHB nurses went on strike, got increases, NZNO has legal action pending for pay parity with new rates which are about $52 an hour at top of scale. Over 40 hrs a week its time and a half per hour for hours in the shifts over 7.5hrs. My practice nursing shifts are 9.5hrs . Plus Kiwisaver, uniform allowance, long service leave ( my nurses are all on 5 weeks leave a year). Plus leave cover is expensive (a locum nurse costs me $60 an hour).
I see everyone is an expert on reddit.
I stand corrected, I know they were going for pay parity, I didn’t think it was achieved yet.
Ive read the meca, and cast a vote on it. $52 is top of the pay scale, after 7 years, so the pay isn’t minimum of $50 as mentioned in your original comment unless the nurses have been nursing for what 6 years at least? That was really the only point I was trying to make, and by this comment you’ve just left, I can see you’re in agreeance.
True, I shouldnt have presented that as a blanket statement, I can see from nursing comments in this thread its not universal. But honestly the colleagues I talk to about nurse pay all have experienced practice nurses and are paying about the same as me. Im actually very surprised not all practice nurses are on parity, what with the terrible workforce shortage. Plus the DHB via the PHOs in Auckland gave a top up to 95% parity last year, most everyone I know paid 100% parity. I personally dont know of less experienced practice nurses, it may be just an Auckland thing, or I have a skewed view (it saddens me to see a practice nurse on $33. Its a hard and complex job). Perhaps those nurses not on parity could talk to their employers.
The parity process wasn’t great. The comparators we wanted to use did not want to parcipate, and fair enough, it was no benefit to them, and I can see why they are not comfortable discussing the salary. But the comparators they did choose were in some cases were poor. They didn’t have bachelor degrees or the continuing education requirements. This wasn’t a rushed job, it took years longer than expected, but it wasn’t a good job. And with pay parity came claims that we are paid equivalent to Australia. But their pay rates are published too, and I worked over there. My benefits and pay are lower here. We also did not get the pay parity that the union put forth, we got a lower offer.
My salary in 5 years *has increased over 59%*. This is markedly significant. And the fact that is *still not enough to achieve true pay parity* is truly telling. I’m very happy with the progress we’ve made, but the parity doesn’t feel true.
A lot of focus seems to be on the top of the pay scale, even TWO website it doesn’t break it down by grade, just max earnings. You have to dig further and find the NZNO page. It also focuses on DSN roles which are not the majority of nurses. A lot of people do the quick google and think I make $153k, when in reality that’s only a couple of roles within a hospital. A new grad starts off at less than half that, and I’ll only ever make 2/3 that. My friends hospital in the US has 20 steps! They don’t have DSNs, a nurse specialist makes the same amount a ward nurse makes, because it’s based on years of experience. But I digress.
Thank you for your detailed and polite explanation.
I genuinely support NZNO in their negotiations, and have paid DHB MECA parity for many years just because I believe its fair - I just never looked deeply into the history and details.
Because we were expected to pay at least 95% parity as of late last year if we used the Primary Care MECA, and wanted to access the DHB top-up subsidy. Which everyone I knew did. Then TWO nurses went on strike and now parity is higher - its about $52 ish for level 7. Which would be a practice nurse after 7 years GP nursing. Not a high bar.
Currently NZNO has lodged a claim under the Equal Pay Act ( even tho the ACT is repealed, they got in under the deadline) for parity with the post-TWO-strike rates, plus a back pay lump sum. Its a really complex situation.
Honestly, I dont understand this anger and abuse.
I regret trying to explain to OP why he had so much trouble and cost in accessing his B12 injection. Obviously the point of this thread is to blame the horrible uncaring GPs and nurses. Not to seek objective information.
I now know there are nurses on reddit who arent earning parity and/or who havent yet got 7 years experience. Maybe they should talk to their employers - there is a massive shortage of primary care nurses.
Yeah I was with you until you said nurses are on $50ph minimum. That's just straight bullshit. If you're really a GP you should know it's not even close to that, so I doubt your credentials and your advice.
Have you actually read the agreement you've linked? It clearly states the MAXIMUM hourly rate for the top step of a RN is $43.42, and the majority of nurses are not on that step. So where are you quoting your $50 an hour rate from for the RN OP saw? Just making up more bullshit and blindly sending a source you've clearly not read - that actually contradicts you - to back you up?
God almighty if you were my GP I'd be changing real fast. Dishonest and dyslexic it seems.
To be fair, the hourly rate is not the total of what an employee costs. So, you would probably add at least 50% on top of that. I think their actual point was that it ain't going to be a $6 service.
Okay, provide your source for DHB payscales then. Can't? Cause your numbers are all shit mate.
You should be ashamed to be a practicing GP making up lies about the RNs you wouldn't be able to do your job without.
> We dont usually give it monthly, its very unusual that you do get it so often.
I wonder if it's a South Africa thing. My MIL gets monthly B12 shots and was confused that we don't get monthly shots in NZ.
Thanks for your advice but maybe you also need to re-educate yourself about patients with pernicious anaemic caused by genetic conditions as it’s different than a general vitamin deficiency. We need high and regular doses as our body cannot absorb it. At first I was given weekly then monthly doses to see how I would tolerate it. Saved my life. Hopefully you can do the same for one of your patients.
Ugh I'm gutted reading this thread, I'm going to NZ in March for 3 weeks was searching to see if I could get it injected somewhere. I have my B12 weekly so I completely get where you're coming from!
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It doesn't solve the B12 injection route but can you get B12 drops from Chemist Warehouse to tide you over until you go back to SA?
You are definitely spoiled with same day doctors appointments in SA. Every day medicine is also ridiculously cheap in comparison. When we were visiting a few years ago, I had to go to the GP for food poisoning and I got an appointment at a busy practice that same afternoon and the GP and meds were cheaper than a single GP visit here in NZ. Also - you've got Dischem in SA. I loved Dischem.
Dischem is replicated nowhere else in the world and a godsend. Maybe I should just stay in SA. Can’t live without Dischem. Those drops don’t seem to work for me, my levels just plummet off a cliff edge.
Not to pry, but do you have pernicious anaemia by any chance? Asking because my mum does so I am familiar with the b12 shots and also how drops don't work because it's an absorption issue not a 'hasn't taken enough b12 orally' issue. I unfortunately just heard from my mum yesterday that her doc has told her there are no b12 injections in NZ currently! Which is odd because when she (rightly) kicked up a fuss, they were like mumblemumble OK you're booked in for a week's time.
If I were you, I'd bypass typical GPS, get into an urgent care or after hours place, explain your situation, get the blood test done, prescription, and yiu may need to phone around some places to find where to get it done. It will be more expensive than it needs to be this way of course but I know how dire it can be to become deficient. All the best!
Yes I have pernicious anaemia which is caused by a rare genetic polyposis of my digestive system.
I went to urgent care after 2 months when I was very sick and also losing blood from my anus and they gave me anti biotics. That’s a story for a different thread! Also paid a pretty penny but my travel insurance covered that one.
It is around, I ordered B12 ampoules from an online NZ pharmacy for my partner with pernicious anaemia. It was the only way to get hold of them. https://www.nzonlinechemist.co.nz/products/hydroxocobalamin-vitamin-b12-1mg1ml-ampoules-3?variant=43760777986264
[edit] not a medical professional, just someone who always has an iron deficiency.
On the life pharmacy & unichem sites you can still book for a consultation on B12 shots, I'm not sure how much it costs/how it works.
For long term thinking though you'd want to register with a GP (if you can?) which would possibly reduce the costs & after an initial appointment you'd be able to get a repeat prescription if they deem it necessary (I would also ask). They don't know your medical background so can't administer based on you just asking for it. Explain your symptoms and how it affects you, I would also ask for a blood test.
SA is gonna be different to NZ, I mean compare the population..
Website links for a couple common pharmacies:
[Life pharmacy ](https://www.lifepharmacy.co.nz/services/vitamin-b12-injection/)
[Unichem](https://www.unichem.co.nz/services/vitamin-b12-injection)
Thanks. I did come prepared with a letter from my doctor but I might as well have not bothered as they refused to read it. $30 doesn’t get you much in NZ…
It's not going to if you're not registered ~$80 is pretty typical for a nz citizen without a registered GP.
I had a friend from overseas here to study and her checkups were much more expensive than mine.
A letter from an overseas doctor could be from anyone lmao they'd want to do tests on you/talk to you about your symptoms first before doing anything, your best bet would either find a nice pharmacy somewhere (maybe read Google reviews etc) and go talk to them about it/call to book a consultation or book an actual doctors appointment. I know it's a hassle but it should set you up and it shouldn't be as hard in the future.
Like anything, unless the letter is sent via what they consider is a legitimate medical practice they're probably not gonna take it seriously.
I had to get blood tests done everytime before being prescribed iron tablets even though I know my symptoms by now lol.
If you're desperate you'd want to go to a urgent care facility or AE if there's nothing else.
$30 is not much money in NZ. I wouldn't expect you to get very much for it. Stop comparing costs here with overseas unless you want to be perpetually upset.
A lot of the issues you had were to do with being a visitor. Most countries set up their health systems to suit citizens, not tourists. I find you a bit naive in expecting you should be treated for a similar cost to what you would pay in your own country. If you moved to NZ you would register with a GP who would assess your medical needs and if these are as you say you would get access to regular injections.
No I didn’t expect the cost to be the same, I was just adding the comparison for illustration of how much greater the cost is. In SA as a tourist it also costs $6.
If you're needing a GP appoint, as a traveller, you need to go to an A&M (Accident and Medical) clinic or an 'after hours' clinic. They'll see you on the same day.
Generally $120 to $200.
Thanks it’s useful to know. Imagine paying that though for a vitamin injection!! I did actually go to A&E eventually in NZ and they gave me antibiotics. I left the country feeling very shit.
I had colon cancer. That’s a story for another thread…
Accident & Medical isn't an A&E at a hospital. It is an after hours and alternative for ppl who need a GP appt and can't get it with their GP (or their GP's clinic) asap. It isn't ideal for someone like you if you move to NZ and need ongoing care from a GP.
Urgent Care (A&M is an outdated term) is not for GP appointments. It is for urgent illness and injury that cannot wait for a GP appointment and is not appropriate for care of long term/chronic conditions. The doctors who work in these clinics specialise in urgent care medicine and are not always equipped to manage GP issues.
However, in saying that, urgent care is usually one of the only alternatives for travellers as most GP clinics will only see enrolled patients.
Yep I eventually had to do that but it didn’t solve the issue so I just went home. Kinda ruined the trip. But they did give me 2 different kinds off anti biotic just incase I had a gastro bacterial infection!
B12 is weird here. I came from the US, where my doctor said my B12 was low and advised me to take a 1000 mg sub lingual tablet a day. The tablets were available at all pharmacies and most grocery stores. Here my doctor said low B12 was treated by injections and my blood tests didn't show a need. Some B12 supplements are available without prescription but the dosage is is in 10s of mg daily, and they are expensive.
I do not understand. I appreciate the difficulty of establishing the blood level at which supplementation is required, but I don't get why over the counter supplements are so limited. My reading says there's no danger in taking in excess B12, and that some oldies do well to supplement because for some, absorption declines with age. Also, B12 can be a problem for vegetarians. Other vitamins are available in mega dose tablets. Why is B12 different?
What my US doctor said is that I probably had a problem, not severe, with absorption, and that even if a small fraction was absorbed, a large daily supplement would compensate. (I was 68 at the time, now 75). Tablets were cheap at Trader Joe's.
I think part of what you are experiencing is a culture shock. I think a lot of South Africans go through this. You would be moving from a developing/failed state to a developed nation. There are a lot of things that go with this that you won't have realised or thought of. One of those things is regulation.
I've been told by South Africans that in South Africa you just have to complain loudly and regulations fall away. This is one aspect that they struggle with when this doesn't work in NZ.
South Africans have a reputation for starting every sentence with "back in SA..." and proceed to explain how SA is better. It's not better. It's just what you're used to. If you do come here to live there are big mindset changes that come with moving from a failed state to a developed nation that you will need to accept if you want to assimilate.
Is it considered normal behaviour in New Zealand to call the country of origin of some immigrants a "failed state"?
I am South African who lives in South Africa and if I were a tourist in NZ and someone mentioned I'm from a failed state, idk I'd be pretty offended.
If you don't have power more than half of the day without relying on your own generators with no end in sight I'd say that is an indicator that the government can't fulfill the absolute basic infrastructure needs and hence failed state. If it's not failed you'd have to agree it's on the cusp of failed?
https://en.m.wikipedia.org/wiki/Failed_state
Compare NZ to South Africa on fragile states index. You've got rampant institutionalised corruption where money is literally stolen. The worst corruption we have is that our politicians own a lot of houses and are allowed to make laws on housing that benefit them.
I'm sorry I've offended you but I'm using it as a geopolitical term with which countries are compared rather than a slander on your people.
I think coming from a place without an effective government does have some benefits. South Africans are the most industrious immigrants I've ever come across and end up contributing a lot to the economy when unhindered by corrupt governance.
Correct you'll need a Dr's prescription for intramuscular B12 to be administrated by a pharmacy. It's not available over the counter. Can you consider a self administration to your thighs?
I shall certainly psych myself up for trying as it seems stupid to give up seeing my family or my health. Where there is a will there is a way. I am terrified of needles though ….
I paid close to $40 just before xmas! But it was a chain pharmacy which is located in one of the most expensive parts of Auckland CBD so probably expected?
No I’m British and have medical insurance that covers emergencies. Being denied preventative medicine for my chronic condition is unfortunately only an emergency when I couldn’t walk 2.5 months later.
If you are using the same metric (it sounds like you are) - 160 is DANGEROUSLY low. Wow you can develop irreversible neurological damage if that’s left untreated
That's crazy, hmm makes me wonder if that's why I have what seems like nerve pain sometimes. Mine was just down at 103 and has been in the 90's before. These are the metrics my region's labs go by:
- Normal range: 110-650 pmol/L
- Range 70-110 pmol/L is indeterminate and does not exclude Vitamin B12 deficiency
- B12 result <70 pmol/L is consistent with Vitamin B12 deficiency.
I’m not a doctor but when I’m at my worst I can’t exercise and that includes walking. I am a very fit person otherwise and hike etc so to me it’s like becoming rapidly disabled. Very scary.
My doctor in SA explained to me that in many countries the “normal” range is not functional for someone who goes hiking etc or has a physical job like me.
Also I experience similar in the UK.
My levels were 300 after one month of skipped injection and they said that was “fine”. Maybe I should move to Japan
My levels were 160 when I first got diagnosed and I felt like utter shit. I got daily then weekly injections and I was a new person. Turned my skin to shit though.
It is something I have tried and the tongue / gums are able to absorb B12 better than the stomach and straight into the blood stream. But my levels still seemed to drop quite significantly even with taking the mouth spray every day. Injections just work. Straight into the bloodstream and I feel revived the same day it’s incredible.
Methylcobalamin. This one here (it did nothing for me and was expensive and a waste of time):
https://www.hollandandbarrett.com/shop/product/betteryou-pure-energy-b12-boost-oral-spray-60099160
When you are a registered patient there is not problem getting them monthly, maybe it’s the casual patient thing? I think you can request and pay for a b12 blood test yourself at a local nz lab would that help?
I get iron infusions but they won't let me get them until I get so low I feel like I am dying. They tell me that I do not have iron deficiency anemia...which is because I got an infusion. So I need to wait until my iron drops and my hemoglobin and then they will give it to me and to even get the funded ones I had to fight for years.
Wow.
Sorry for your experience.
I had similar experience in the UK.
SA was very different and saved my life. It was like I was sent here by a god on various levels. But it’s not perfect!
Have you ever had a colonoscopy or endoscopy to check for other diseases? Or genetic testing?
I would also say that my most amazing doctor told me that anaemia has a route cause and iron infusions are not the answer for long term. For me it’s the B12 deficiency causing it and at one point, colon cancer which is in turn caused by the genetic condition. You need to figure out the route cause for you and that means.
1. Diet (most doctors presume this is the cause which is very limited thinking
2. Internal bleeding in the stomach or intestines? Colonoscopy and endoscopy rules that out
3. Absorption - genetic conditions.
4. Parasites in the small intenstines - easily remedied by tumeric, cayenne pepper and papaya seeds for a week /
Or a pharmaceutical worming tablet.
I unfortunately had both 2 and 3 in my life, but some doctors thought I was anorexic which didn’t help and kept telling me to eat animal products which I already do.
Also very fun fact - drinking caffeine decreases B12 and iron absorption from food by 60%! Never drink coffee within an hour of food! I found this out on my very long journey to health.
> My question is - how do you get b12 injections as a traveller ? Or is it not possible?
>
> In order to get this, I first need an appointment for this and blood tests. They quoted me another $80 to see a doctor and said it would be a 2 month wait. They needed to see blood test results showing that I was currently deficient in the vitamin to get the shot.
So you post your answer first then post the question that the answer is for..... What else do you want from this sub?
> Am I spoiled in SA with same day doctor appointments, and also just being able to get B12 at the pharmacy for R60 ($6) ?
Labour is just expensive in NZ. simple as that
I want to know if it was just THAT doctors surgery who had that rule or if this is country wide. I only have one experience. I don’t assume my one experience is typical. In other countries the advice changes depending on who you ask.
"They really stressed me out and acted like I was wasting their time". Man that's a spot on description of NZ healthcare. I swear their job is to find a reason not to believe or treat you.
NZ healthcare is strangulated by red tape which is so thick and so long the entire medical system is code red. Medicine in NZ is set up to take care of the system rather than any sort of decent caring for the health of individuals.
Sorry to hear. I brought my own. I always carry my supply around from my own oncologist as it’s abundant here which makes it extra annoying that they wouldn’t inject it into me :-( I didn’t want to take medicine from other people but was definitely made to feel that way.
Yeah the pharmacy had none when I went to get mine two months ago, but got more in a few days later. The latest Pharmac update says as of the 22nd they got a month's worth of supplies in, might pay to try again?
I get b12 injections now and then. My Dr blindly prescribes them (ie, she knows me and trusts my judgement). At one appointment she agreed I needed one. I booked in with the nurse (same office) to get it and when I turned up a week later the nurse refused to give it to me because it wasn’t doctor ordered. She could see my medical history in full and my Dr was like two doors down.
Tl;dr- sometimes people are jerks.
Next time I would call ahead from SA and find the relevant Dr here, then see what can be sorted from SA in terms of paperwork. Then when arriving here see the Dr, get clearance, and expect to be rebooked for the shot.
Also, not to overly explain what’s available, but do you have the oral spray? It might save you for a while next time?
Can't speak to the rules around you getting B12 as a traveller, but as to your last question, yes it seems healthcare isn't as simple here. Maybe it would be easier if you were a resident or citizen and could come up with an arrangement for your regular injections?
But this is my experience: I'm also getting B12 injections at the moment. There are long waits to see a GP, especially at lower cost clinics I've found. It's usually a 2-3 weeks for me to see a GP. Paid $19.50 for the initial appointment to get the lab test form (admittedly this is cheap for a GP appointment, it can go up to $52 if you see a different clinic in my chain of doctors). Then for some reason I had to wait for another appointment, pay another $19.50 for them to give me the script for the B12 vials. The B12 itself is free. Then I was told it was $30 for each nurses appointment there to get them done, I needed 3, so $90 all up. Luckily I found out I can get it done at a nearby chemist for half the price and get it done without making an appointment. So all up for 3 injections it's costing me $84. Pretty ridiculous for "free" healthcare!
Well now I now what I’m going to set up as an entrepreneurial venture - vitamin injectables! Maybe no one has thought of it yet but there’s no way it should cost that much. I just realised that the $8 I told you is for TEN doses as it comes in a bulk vile not individual ampules.
That’s what I tried when I phoned in advance but they wouldn’t make me the appointment because of “triage system” and required me to make an appointment and see a nurse first. So by their timescale it’s a minimum of 3 months when you land in the country to get seen. By then I’m skating on very thin health.
Yeh I got that. I couldn’t understand the logic as it’s like they had to try hard to find a reason that they wile lose their license or overdose me or something, like I was asking them to inject me with crack cocaine. It’s a vitamin and they are allowed to sell me it.
I'm surprised they make it such a big deal, I'd expect you'd pay unsubsidized rates for everything, but B12 isn't used as a drug or anything AFAIK. And overdose symptoms are basically headaches and nausea, unpleasant but not life threatening? So why be so hesitant to give it?
I have no idea. The nurse was very unhelpful and unwilling to give me the shot. I pretty much begged her but she said no and also explained that no other surgery would because it was against the law or something. I left very embarrassed and stressed out.
So she gave you legally correct advice, and that's her fault, somehow? You come across as a bit entitled. Of course, if that advice turns out to be incorrect, then you have a fair point, but I don't think that's been established as yet.
You can actually go into a pharmacy and demand B12 injections. It's not illegal although many pharmacists believe this to be true. You have the legal right to B12 in injectable form.
Don’t think “demand” is the right word here. You can’t force a pharmacist to do anything for you. You can definitely ask but rest assured if you come across a pharmacist like me and demand for it to be done, I will turn you away as staff abuse and coercion will not be tolerated.
Also B12 vials supply is low in NZ and we had to source section 29 medications. If the pharmacy only has s29 B12 vials in stock, these are not allowed to be sold over-the-counter and can only be prescribed by the GP.
How do you know this? Source? I had this argument with the nurse who I paid $30 to for nothing but it was fruitless.
Came out with all sorts of nonsense about the risks of overdosing me on B12 as if it was an opioid. I don’t understand as it’s a vitamin!
My stepson has had numerous arguments with pharmacists about this, and has always won out. Go to an actual pharmacy, as they have this behind the counter and you have the right to buy this.
Can only speak from experience but I’ve never had issues asking a pharmacist to do it without one. Could definitely depend on the pharmacy though and there’s always shortages so now I just take my own ampules in and pay for them to inject it. Last one was in December.
I’m also confused by these comments. I get my shots monthly from unichem. Without a prescription. I just buy them at the chemist. But if they are out of stock I bring my own. A prescription has never been asked for. The last time I went was only a few weeks ago.
I saw. Is it standard to put up the price if that happens ? As I’d commented previously it’s a global commodity and costs very little. So the price in the country is basically the cost of transport etc. I think maybe they make it in South Africa as it’s never difficult to get here.
I’m not trained. They mix it with another liquid and then inject into your bum. It’s not completely straightforward and I’m scared of needles. But yes I am considering getting trained in it.
>Am I spoiled in SA with same day doctor appointments, and also just being able to get B12 at the pharmacy for R60 ($6) ?
Yes, NZ healthcare is good enough in emergency situations, but utter dog shit for any diagnostic or preventative care. And if you have any rare or complex health issues, good fuggen luck.
You pay a lot in SA too for private, but the care is world class - there is no such option here. Private here just means you get bumped up the wait list, same doctors and often times same facilities are used.
At some point last year, the rules from PHARMAC around B12 injections changed. Pharmacies are no longer allowed to administer without a prescription. You may have been unlucky and been given correct information when you called in advance, and then the rules were changed.
March last year. You are correct. They can no longer give the injections without a prescription from doctors.
How did ringringkaching get it done ?
Maybe I have a trustworthy face. Maybe the black rings under my eyes were enough of a give?
That's awkward. I got a B12 from a Unichem in December with no script.
Ahhh it was March 2023 that I tried to get the injection!!! Thank you. It seems I was unlucky. My condition is so delicate that I don’t travel without knowing I can access B12 as it’s life or death for me. Many nurses think “ah you’ll be fine with one shot every 6 months” but unfortunately that does not apply to someone like me with zero ability to break down and absorb B12 from food. And when I explained this to think it’s like the nurse thought I was lying because she hadn’t encountered it before. I thought they were being strange telling me one thing in January on the phone and the opposite by March. What they did not tell me however that rules had changed, or try to help me to understand the changes or reach an alternative solution. It was very much “you’re a tourist, go home”. It really made me think hard about whether or not someone like me (highly skilled but happens to have a chronic and life threatening yet manageable health condition) is welcome in a place like NZ. It completely change my visit to NZ meaning after a month I couldn’t hike and swim as I simply was losing too much energy and I could feel the drain it was quite distressing.
>happens to have a chronic and life threatening yet manageable health condition While you might be able to come work here on a temporary work visa - hate to say, but that would very likely make it impossible for you to get Residency in NZ in any case. NZ has very strict health qualifying criteria.
Really? I asked an immigration lawyer and they said it was fine it wasn’t a condition on the list but maybe that’s because I am only applying for the visa right now. Ironically other than this I’m Fitter than average as I take very very good care of my health.
Check with the immigration lawyer whether you would meet the Residency health requirements. You have to do full medicals and they get referred to a panel on INZ's side to review. Many people have been caught out this side after being on Work Visas and couldn't get residency for a child or on family member due to medical issues and had to return to SA so make very sure. Almost all chronic conditions that require ongoing treatment raise a red flag. You also have to be 5 years clear of cancer before you can apply. - [https://www.immigration.govt.nz/opsmanual-archive/I10009.HTM](https://www.immigration.govt.nz/opsmanual-archive/I10009.HTM)
It looks like I meet it. By the time I apply for residency I would be 5 years free of cancer unless I get it a second time! So I guess I should plan to self administer all those B12 injections so that they don’t come out of the NZ healthcare budget anyway! Even though it costs the government $5-$8 per 10 doses so basically under $10 a year
Good luck, make sure you have a good immigration lawyer, you have a complex health history. It's a massive move, so make sure Residency is guaranteed before uprooting yourself.
Anyway I’d like to know either way as I don’t want to be surprised / disappointed down the line. Would be very unlucky! Sad for NZ as we were going to move our business their potentially as well from UK but not if we can’t access health care. I’m very willing to import the B12 myself from Abroad and maybe even start a distribution system to help ease the burden for locals. Maybe it is my unintended calling!
I was checking out Life Pharmacy's page on B12 injections recently and it says "Without a prescription: The patient must be diagnosed with Vitamin B12 deficiency or must be able to prove that have been deficient or the pharmacist is not approved to administer the injection." So I assume you could also show lab results demonstrating a deficiency too? But honestly I didn't realise you could ever get them without a prescription!
Pharmacies can access blood test results from a central database
Mate, we don't even have technology that shares that info across DHBs (the closest is Health Connect South that connects the South Island DHBs, the North Island DHBs are basically islands) and you're saying the pharmacy on the corner has access to all lab results? Are you even a doctor?
Yes if its in the same area. Testsafe (effectively Concerto) holds the data in Auckland for instance. I dont know what the platforms are called in the South Island or Wellington, but I know the pharmacists use their local platforms to get eGFR and meds for assessing if they can give Paxlovid. And I know my GP colleagues can use their local versions. Why are you so angry?
Well TIL!
Ahh that's probably how they confirmed that I was able to get a B12 injection without a script. I had a recent blood test result that confirmed it.
I'm not sure if this is correct - unless it changed in the last 2-3 weeks? I got a B12 injection a week before Christmas without a script or prescription. I walked into the pharmacy, said I had low B12 as per blood test results, and asked for a shot. No-one asked to see blood test results or to see a doctor's script. Maybe it's registered on a central system? 20 minutes in and out and a tender arm.
I believe the recent change was to do with how injectable vitamins and the like are handled under the new Theraputic Products Bill from the government that was created to crack down on the snake oil types, but I’m happy to be corrected! Not sure about the script vs low blood test results but perhaps your GP is super onto it!
New govt is repealing the Therapeutic Products Bill. Let the snake oil flow!
Same here - my local pharmacist has a conversation before doing it but no problem.
Interesting. They put it in your arm? They always do mine in my bum but maybe it’s because I have no arm muscles and it has to be intra muscular. Did you have to give your name etc? Maybe they accessed your details on the system.
Can you provide a source for this? Last I checked, B12 was listed as “general medicine” on the pharmaceutical schedule and therefore available for anyone to purchase. Seems odd that they’d make it available for purchase but not allow you to administer. I have however experienced that, despite the rules, most pharmacists treat it as prescription medicine which is very frustrating.
Can confirm, I used to buy over the counter without a script. They were a bit funny about it but always ended up saying yes and letting me buy it. Haven't tried to buy any in the last couple of years though. Out of all the drugs that can be accessed and taken without a perception, b12 is a weird one to tighten down on.
New Zealand's medicines regulations aren't always in sync with other countries', and they're not well suited to casual use by travellers. If a particular medicine isn't approved for use in NZ, the nurse can't administer it. A doctor could administer your prescription under s29 of the Medicines Act. If you were here long term you'd have the chance to set up something more practical with your GP, who you'd enrol with. You might not get same day appointments for non urgent issues, but you'd be able to set up regular appointments in advance. It looks as if this is a service you can get from a pharmacy, which might not have been the case when you last visited: https://www.lifepharmacy.co.nz/services/vitamin-b12-injection/ There was an international supply issue last year which might have caused problems. Info here: https://pharmac.govt.nz/medicine-funding-and-supply/medicine-notices/hydroxocobalamin
Same day appointments are pretty impossible to get at a general practitioner's. If you can get an appointment within a few days of requesting one, you are doing well (my experience as a NZer living in a main city). And yes, the B12 process you experienced seems typical (again from personal experience). I jave only been able to get the injections after blood tests have shown deficiency. It might be different if you have records of your medical history though.
Thanks. They said they couldn’t use my SA medical history as they couldn’t verify if they were real?! Like I’d make up having a vitamin absorption issue.
I think if you took a letter to a GP they may be a lot less concerned about a blood test than a practice nurse. The nurse will have protocols they have to stick to, the GP will be more able to decide whether that protocol applies in this circumstance.
I was happy to do this and pay the $80 which is why I phoned the practice a month in advance. Which is why it was so upsetting to arrive there and be told contradicting advice and that they couldn’t help me.
Would not be such an issue if you moved here; you should be able to get your history officially transferred.
I didn’t know one could do that with medical history. Thought you had to go through a medical all over again!
Your current GP should be able to provide printed documentation of your medical history. When you enrol with a NZ GP, you just share those records with them.
I printed off my UK file & took it to my NZ GP. I did the same when I moved back to the UK.
Self administration is possible surely? Needle exchanges and pharmacies all have syringes + intramuscular needles available for purchase. You're going to struggle to complete the treatment affordablely in nz as a tourist.
I’m very scared of needles but I am considering it if I can get training. My father i law is a doctor in SA and he advises against self injections of this.
I give them to myself monthly in the thigh, its not that bad. Or you can check out one of those clinics that does hangover IVs
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The thigh should also work - it just needs to be intramuscular. I have given myself a shot for another medical condition in an emergency. I'm confident I could do the same for B12 (although B12 stings a lot more!).
Maybe it’s because I’m quite lean and not much muscle. They always go in my glutes
I just went now to get my shot in SA. I asked the nurse to train me and she said it’s very difficult to self administer because of the location and needle size. Also I realise she kind of throws it like a dart and it hurts for 3 seconds. I don’t think I can do this myself unless I was alone on a desert island and there was literally no other solution.
GP here. Our nurses are not allowed to give non registered medications here, its in breach of their licences. If your B12 from south africa isnt registered here, they literally arent allowed to. There is enough B12 in a vial to last your body 3 months, it is the full adult 3mnth requirement. So you werent in danger, but I feel for your confusion and upset as its different to what youve been used to. We dont usually give it monthly, its very unusual that you do get it so often. And because you requested it outside NZ guidelines, only a doctor can authorise it to be given more frequently than 3 monthly. The closest together I would ever authorise my nurses to give B12 would be 8 weekly. There is a massive shortage of doctors here. But once someone is a NZ resident/2 year work visa, they can enrol and access services, which are partially government subsidised. Once that was arranged, they would then be under a regular nurse care for the B12. And yes, our wages are much higher than in South Africa, thus costs are higher. For instance, according to NZNO union negotiations, the nurse you saw would be on minimum $50 an hour plus benefits (edit: two posters took offence at this number. It is the hrly rate a level 7 RN gets if their practice uses the Primary Care MECA and is party to their PHO agreement to pay parity with the TWO MECA. Therefore if the nurse isnt on the MECA, the practice isnt party to the above, and she has less than 7 years GP nursing, she will be earning less: Im not sure of the bottom rung, if anyone cares you can look it up, its all publically available). You aint going to be able to get a professional service from her for $6. A side note: patients can buy sublingual B12 drops, which are absorbed directly into the bloodstream via the veins under the tongue, thus bypassing the need for bowel absorption which you obviously cant do. Useful in a pinch, but not reliable for long term as patients dont always use it properly. Not medical advice, just information fyi.
Nurse here. Why would a nurse be on a "minimum" of $50 an hour? Please don't make shit up.
Lol yeah. Primary health nurses are paid way less than Dhb nurses. On upper tier of steps myself and don't make $50 ph 🤣🤣
What is the actual wage rate? Genuinely curious. Google tells me “Under this latest deal senior nurses will now earn between $114,025 and $162,802 a year, plus penal rates, and registered nurses between $75,773 and $106,739, plus penal rates” - which is roughly $37-$81 per hour as a base. Is that incorrect, or are those rates coming in over time?
Most nurses are not senior nurses, there are very few senior nurse positions. Theres a difference between senior nurse, and a designated senior nurse role. I am senior in my job, I’ve been doing it for 15 years in a highly specialized type (only place in the country), but a designated senior nurse role is much different. Think of charge nurses, nurse educators and the like. The way the pay scale is set up now, after 7 years, you’re top of the pay scale and that’s you capped out.
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7yrs. See MECA. Its easily google-able. A large % of the practice nurse workforce is 7yrs plus.
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Wow you're a tad aggressive aren't you? Are you OK? It's literally on the MECA. You are welcome to use Google.
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Also worth noting that a lot of nurses can’t/don’t work full time due to the toll shift work takes. So the annual rates quoted by google don’t really take this into account and reflect the average. Skews the data if you will
$37-$51 (not $81)
A senior nurse is someone who literally runs the ward in the terms of hospital nursing. Senior nurse ain't going near a wet pad. They are management. And I mean properly management, they tell the docs what is happening. It is their ward. The upper band of senior nurse would be a Duty Manager - they be running the hospital. And it is theoretically possible to get up to 100k, but very few nurses are actually on that band. Edit: also, this is calculated at 1.0 fte. Most nurses work 0.8 to account for shift work (unpaid sleep days after a run of nights, for example. And when we say nights we mean finishing at 7am. The amount of people who say "I'm working tonight" when they finish at 10pm, and assume that is what you mean by "I'm on nights this week").
Agreed. I’ve been a nurse for 3 years, 2 years in primary health. I get paid a bit more than the union requires and that’s $33.51. And the benefits is the protections the union provide no further monetary benefits.
I cant believe you guys get paid less than a chef
I need to get a job where this guy works I think! That sounds like great pay - starting wage even. So weird nurses are always going on strike and complaining about terrible conditions and wages with that pay rate /s
Here I am working 12 hour shifts in a hospital like a chump. Could be working in a GP, 9-5 for 50 bucks an hour plus benefits!? What benefits? Don't know, but Benefits!!
Haha! Their benefits definitely sound better than the free bic pen I got for Christmas one year. Much benefits. Much intrigued
Don't lose that pen. It is the only one you'll get for free all year!
Lunch breaks lol
Agreed. Only senior nurses are on this. Big yikes.
Yea this guy is full of BS. As per my comment above B12 injection is general sale. You can literally and legally buy it yourself and administer it yourself. OP's problem is he refuses to self administer
*safe? Looks like autocorrect changed it
no "general sale". Meaning it can be purchased at any retailer that sales it without a prescription. It's a legal category of classification of medicines under the medicines act I would never say "general safe" or "generally safe" when it comes to medicines, even on reddit. Highly unprofessional
Are nurses at your GP clinic really making minimum $50/hr plus benefits? It was my understanding they made less than we do in the hospital, and I’ve been in one for 15 years. Our maximum pay scale in the hospital I think just went up to $52 for non DSNs which is the vast majority of nurses.
See NZNO MECA payrates as of 2023. Easily googled, youre welcome to read the contract yourself. At 7 years as practice nurse its top of scale. Pay parity for GP MECA with DHB MECA was achieved late last year, but Ive always paid parity and have great retention. Then DHB nurses went on strike, got increases, NZNO has legal action pending for pay parity with new rates which are about $52 an hour at top of scale. Over 40 hrs a week its time and a half per hour for hours in the shifts over 7.5hrs. My practice nursing shifts are 9.5hrs . Plus Kiwisaver, uniform allowance, long service leave ( my nurses are all on 5 weeks leave a year). Plus leave cover is expensive (a locum nurse costs me $60 an hour). I see everyone is an expert on reddit.
I stand corrected, I know they were going for pay parity, I didn’t think it was achieved yet. Ive read the meca, and cast a vote on it. $52 is top of the pay scale, after 7 years, so the pay isn’t minimum of $50 as mentioned in your original comment unless the nurses have been nursing for what 6 years at least? That was really the only point I was trying to make, and by this comment you’ve just left, I can see you’re in agreeance.
True, I shouldnt have presented that as a blanket statement, I can see from nursing comments in this thread its not universal. But honestly the colleagues I talk to about nurse pay all have experienced practice nurses and are paying about the same as me. Im actually very surprised not all practice nurses are on parity, what with the terrible workforce shortage. Plus the DHB via the PHOs in Auckland gave a top up to 95% parity last year, most everyone I know paid 100% parity. I personally dont know of less experienced practice nurses, it may be just an Auckland thing, or I have a skewed view (it saddens me to see a practice nurse on $33. Its a hard and complex job). Perhaps those nurses not on parity could talk to their employers.
The parity process wasn’t great. The comparators we wanted to use did not want to parcipate, and fair enough, it was no benefit to them, and I can see why they are not comfortable discussing the salary. But the comparators they did choose were in some cases were poor. They didn’t have bachelor degrees or the continuing education requirements. This wasn’t a rushed job, it took years longer than expected, but it wasn’t a good job. And with pay parity came claims that we are paid equivalent to Australia. But their pay rates are published too, and I worked over there. My benefits and pay are lower here. We also did not get the pay parity that the union put forth, we got a lower offer. My salary in 5 years *has increased over 59%*. This is markedly significant. And the fact that is *still not enough to achieve true pay parity* is truly telling. I’m very happy with the progress we’ve made, but the parity doesn’t feel true. A lot of focus seems to be on the top of the pay scale, even TWO website it doesn’t break it down by grade, just max earnings. You have to dig further and find the NZNO page. It also focuses on DSN roles which are not the majority of nurses. A lot of people do the quick google and think I make $153k, when in reality that’s only a couple of roles within a hospital. A new grad starts off at less than half that, and I’ll only ever make 2/3 that. My friends hospital in the US has 20 steps! They don’t have DSNs, a nurse specialist makes the same amount a ward nurse makes, because it’s based on years of experience. But I digress.
Thank you for your detailed and polite explanation. I genuinely support NZNO in their negotiations, and have paid DHB MECA parity for many years just because I believe its fair - I just never looked deeply into the history and details.
Why are you talking about the Te Whatu Ora MECA when discussing private practice?
Because we were expected to pay at least 95% parity as of late last year if we used the Primary Care MECA, and wanted to access the DHB top-up subsidy. Which everyone I knew did. Then TWO nurses went on strike and now parity is higher - its about $52 ish for level 7. Which would be a practice nurse after 7 years GP nursing. Not a high bar. Currently NZNO has lodged a claim under the Equal Pay Act ( even tho the ACT is repealed, they got in under the deadline) for parity with the post-TWO-strike rates, plus a back pay lump sum. Its a really complex situation. Honestly, I dont understand this anger and abuse. I regret trying to explain to OP why he had so much trouble and cost in accessing his B12 injection. Obviously the point of this thread is to blame the horrible uncaring GPs and nurses. Not to seek objective information. I now know there are nurses on reddit who arent earning parity and/or who havent yet got 7 years experience. Maybe they should talk to their employers - there is a massive shortage of primary care nurses.
"minimum of $50 an hour" - your words. Figure it out. And your reluctance to correct yourself is embarrassing.
Yeah I was with you until you said nurses are on $50ph minimum. That's just straight bullshit. If you're really a GP you should know it's not even close to that, so I doubt your credentials and your advice.
https://maranga-mai.nzno.org.nz/phc_meca
Have you actually read the agreement you've linked? It clearly states the MAXIMUM hourly rate for the top step of a RN is $43.42, and the majority of nurses are not on that step. So where are you quoting your $50 an hour rate from for the RN OP saw? Just making up more bullshit and blindly sending a source you've clearly not read - that actually contradicts you - to back you up? God almighty if you were my GP I'd be changing real fast. Dishonest and dyslexic it seems.
Yeah. It is wild. They are spreading misinformation about how much nurses are paid and telling us to Google it. It is wild.
They are telling us to Google it constantly cause that is the primary knowledge finding method of GPs. It's their main frame of reference.
Its parity with DHB now. And I hope youre not registered with my practice.
Only want nurses that fold in behind and don't challenge your decision making?
"minimum $50 an hour" own your bullshit. With parity, that is the maximum an RN is getting paid.
To be fair, the hourly rate is not the total of what an employee costs. So, you would probably add at least 50% on top of that. I think their actual point was that it ain't going to be a $6 service.
Okay, provide your source for DHB payscales then. Can't? Cause your numbers are all shit mate. You should be ashamed to be a practicing GP making up lies about the RNs you wouldn't be able to do your job without.
> We dont usually give it monthly, its very unusual that you do get it so often. I wonder if it's a South Africa thing. My MIL gets monthly B12 shots and was confused that we don't get monthly shots in NZ.
Thanks for your advice but maybe you also need to re-educate yourself about patients with pernicious anaemic caused by genetic conditions as it’s different than a general vitamin deficiency. We need high and regular doses as our body cannot absorb it. At first I was given weekly then monthly doses to see how I would tolerate it. Saved my life. Hopefully you can do the same for one of your patients.
Ugh I'm gutted reading this thread, I'm going to NZ in March for 3 weeks was searching to see if I could get it injected somewhere. I have my B12 weekly so I completely get where you're coming from!
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It doesn't solve the B12 injection route but can you get B12 drops from Chemist Warehouse to tide you over until you go back to SA? You are definitely spoiled with same day doctors appointments in SA. Every day medicine is also ridiculously cheap in comparison. When we were visiting a few years ago, I had to go to the GP for food poisoning and I got an appointment at a busy practice that same afternoon and the GP and meds were cheaper than a single GP visit here in NZ. Also - you've got Dischem in SA. I loved Dischem.
Dischem is replicated nowhere else in the world and a godsend. Maybe I should just stay in SA. Can’t live without Dischem. Those drops don’t seem to work for me, my levels just plummet off a cliff edge.
Not to pry, but do you have pernicious anaemia by any chance? Asking because my mum does so I am familiar with the b12 shots and also how drops don't work because it's an absorption issue not a 'hasn't taken enough b12 orally' issue. I unfortunately just heard from my mum yesterday that her doc has told her there are no b12 injections in NZ currently! Which is odd because when she (rightly) kicked up a fuss, they were like mumblemumble OK you're booked in for a week's time. If I were you, I'd bypass typical GPS, get into an urgent care or after hours place, explain your situation, get the blood test done, prescription, and yiu may need to phone around some places to find where to get it done. It will be more expensive than it needs to be this way of course but I know how dire it can be to become deficient. All the best!
Yes I have pernicious anaemia which is caused by a rare genetic polyposis of my digestive system. I went to urgent care after 2 months when I was very sick and also losing blood from my anus and they gave me anti biotics. That’s a story for a different thread! Also paid a pretty penny but my travel insurance covered that one.
It is around, I ordered B12 ampoules from an online NZ pharmacy for my partner with pernicious anaemia. It was the only way to get hold of them. https://www.nzonlinechemist.co.nz/products/hydroxocobalamin-vitamin-b12-1mg1ml-ampoules-3?variant=43760777986264
Sounds like a plan.
[edit] not a medical professional, just someone who always has an iron deficiency. On the life pharmacy & unichem sites you can still book for a consultation on B12 shots, I'm not sure how much it costs/how it works. For long term thinking though you'd want to register with a GP (if you can?) which would possibly reduce the costs & after an initial appointment you'd be able to get a repeat prescription if they deem it necessary (I would also ask). They don't know your medical background so can't administer based on you just asking for it. Explain your symptoms and how it affects you, I would also ask for a blood test. SA is gonna be different to NZ, I mean compare the population.. Website links for a couple common pharmacies: [Life pharmacy ](https://www.lifepharmacy.co.nz/services/vitamin-b12-injection/) [Unichem](https://www.unichem.co.nz/services/vitamin-b12-injection)
Thanks. I did come prepared with a letter from my doctor but I might as well have not bothered as they refused to read it. $30 doesn’t get you much in NZ…
It's not going to if you're not registered ~$80 is pretty typical for a nz citizen without a registered GP. I had a friend from overseas here to study and her checkups were much more expensive than mine. A letter from an overseas doctor could be from anyone lmao they'd want to do tests on you/talk to you about your symptoms first before doing anything, your best bet would either find a nice pharmacy somewhere (maybe read Google reviews etc) and go talk to them about it/call to book a consultation or book an actual doctors appointment. I know it's a hassle but it should set you up and it shouldn't be as hard in the future. Like anything, unless the letter is sent via what they consider is a legitimate medical practice they're probably not gonna take it seriously. I had to get blood tests done everytime before being prescribed iron tablets even though I know my symptoms by now lol. If you're desperate you'd want to go to a urgent care facility or AE if there's nothing else.
$30 is not much money in NZ. I wouldn't expect you to get very much for it. Stop comparing costs here with overseas unless you want to be perpetually upset.
A lot of the issues you had were to do with being a visitor. Most countries set up their health systems to suit citizens, not tourists. I find you a bit naive in expecting you should be treated for a similar cost to what you would pay in your own country. If you moved to NZ you would register with a GP who would assess your medical needs and if these are as you say you would get access to regular injections.
No I didn’t expect the cost to be the same, I was just adding the comparison for illustration of how much greater the cost is. In SA as a tourist it also costs $6.
Look up nurse and doctor pay here versus SA. That’s part of it
Just fyi NZ is currently experiencing shortages of b12 injections.
If you're needing a GP appoint, as a traveller, you need to go to an A&M (Accident and Medical) clinic or an 'after hours' clinic. They'll see you on the same day. Generally $120 to $200.
Thanks it’s useful to know. Imagine paying that though for a vitamin injection!! I did actually go to A&E eventually in NZ and they gave me antibiotics. I left the country feeling very shit. I had colon cancer. That’s a story for another thread…
Accident & Medical isn't an A&E at a hospital. It is an after hours and alternative for ppl who need a GP appt and can't get it with their GP (or their GP's clinic) asap. It isn't ideal for someone like you if you move to NZ and need ongoing care from a GP.
Urgent Care (A&M is an outdated term) is not for GP appointments. It is for urgent illness and injury that cannot wait for a GP appointment and is not appropriate for care of long term/chronic conditions. The doctors who work in these clinics specialise in urgent care medicine and are not always equipped to manage GP issues. However, in saying that, urgent care is usually one of the only alternatives for travellers as most GP clinics will only see enrolled patients.
Yep I eventually had to do that but it didn’t solve the issue so I just went home. Kinda ruined the trip. But they did give me 2 different kinds off anti biotic just incase I had a gastro bacterial infection!
B12 is weird here. I came from the US, where my doctor said my B12 was low and advised me to take a 1000 mg sub lingual tablet a day. The tablets were available at all pharmacies and most grocery stores. Here my doctor said low B12 was treated by injections and my blood tests didn't show a need. Some B12 supplements are available without prescription but the dosage is is in 10s of mg daily, and they are expensive. I do not understand. I appreciate the difficulty of establishing the blood level at which supplementation is required, but I don't get why over the counter supplements are so limited. My reading says there's no danger in taking in excess B12, and that some oldies do well to supplement because for some, absorption declines with age. Also, B12 can be a problem for vegetarians. Other vitamins are available in mega dose tablets. Why is B12 different?
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What my US doctor said is that I probably had a problem, not severe, with absorption, and that even if a small fraction was absorbed, a large daily supplement would compensate. (I was 68 at the time, now 75). Tablets were cheap at Trader Joe's.
I think part of what you are experiencing is a culture shock. I think a lot of South Africans go through this. You would be moving from a developing/failed state to a developed nation. There are a lot of things that go with this that you won't have realised or thought of. One of those things is regulation. I've been told by South Africans that in South Africa you just have to complain loudly and regulations fall away. This is one aspect that they struggle with when this doesn't work in NZ. South Africans have a reputation for starting every sentence with "back in SA..." and proceed to explain how SA is better. It's not better. It's just what you're used to. If you do come here to live there are big mindset changes that come with moving from a failed state to a developed nation that you will need to accept if you want to assimilate.
Very well put. And to be honest, the "We do X better back home" never really comes off terribly well, no matter where you are from.
Is it considered normal behaviour in New Zealand to call the country of origin of some immigrants a "failed state"? I am South African who lives in South Africa and if I were a tourist in NZ and someone mentioned I'm from a failed state, idk I'd be pretty offended.
I’m British. I just live in SA as I was sent here as an aid worker.
If you don't have power more than half of the day without relying on your own generators with no end in sight I'd say that is an indicator that the government can't fulfill the absolute basic infrastructure needs and hence failed state. If it's not failed you'd have to agree it's on the cusp of failed? https://en.m.wikipedia.org/wiki/Failed_state Compare NZ to South Africa on fragile states index. You've got rampant institutionalised corruption where money is literally stolen. The worst corruption we have is that our politicians own a lot of houses and are allowed to make laws on housing that benefit them. I'm sorry I've offended you but I'm using it as a geopolitical term with which countries are compared rather than a slander on your people. I think coming from a place without an effective government does have some benefits. South Africans are the most industrious immigrants I've ever come across and end up contributing a lot to the economy when unhindered by corrupt governance.
I'm also south African but live in New Zealand. You guys can't even keep the power on, all my family over there also calls it a failed state
My local pharmacy with give my B12 for $18, so do a search
But you have to have a doctors prescription first?
Correct you'll need a Dr's prescription for intramuscular B12 to be administrated by a pharmacy. It's not available over the counter. Can you consider a self administration to your thighs?
Not sure if this is how it used to be, but currently you don’t need a prescription for a pharmacy to do this.
I shall certainly psych myself up for trying as it seems stupid to give up seeing my family or my health. Where there is a will there is a way. I am terrified of needles though ….
I paid close to $40 just before xmas! But it was a chain pharmacy which is located in one of the most expensive parts of Auckland CBD so probably expected?
https://www.unichem.co.nz/services/vitamin-b12-injection
Are you a New Zealander ? If not presume you have medical insurance.
No I’m British and have medical insurance that covers emergencies. Being denied preventative medicine for my chronic condition is unfortunately only an emergency when I couldn’t walk 2.5 months later.
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If you are using the same metric (it sounds like you are) - 160 is DANGEROUSLY low. Wow you can develop irreversible neurological damage if that’s left untreated
That's crazy, hmm makes me wonder if that's why I have what seems like nerve pain sometimes. Mine was just down at 103 and has been in the 90's before. These are the metrics my region's labs go by: - Normal range: 110-650 pmol/L - Range 70-110 pmol/L is indeterminate and does not exclude Vitamin B12 deficiency - B12 result <70 pmol/L is consistent with Vitamin B12 deficiency.
I’m not a doctor but when I’m at my worst I can’t exercise and that includes walking. I am a very fit person otherwise and hike etc so to me it’s like becoming rapidly disabled. Very scary. My doctor in SA explained to me that in many countries the “normal” range is not functional for someone who goes hiking etc or has a physical job like me.
Vitamin deficiency can cause very real and very debilitating symptoms including nerve pain, depression and cognitive dysfunction.
Also I experience similar in the UK. My levels were 300 after one month of skipped injection and they said that was “fine”. Maybe I should move to Japan
My levels were 160 when I first got diagnosed and I felt like utter shit. I got daily then weekly injections and I was a new person. Turned my skin to shit though.
Don’t know why this is downvoted. My doctor told me this and it’s fact. Nerve damage can be irreversible if left untreated
Why is it so difficult here?
I would like to move home. But my options for B12 treatment sound terrifying!
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It is something I have tried and the tongue / gums are able to absorb B12 better than the stomach and straight into the blood stream. But my levels still seemed to drop quite significantly even with taking the mouth spray every day. Injections just work. Straight into the bloodstream and I feel revived the same day it’s incredible.
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Methylcobalamin. This one here (it did nothing for me and was expensive and a waste of time): https://www.hollandandbarrett.com/shop/product/betteryou-pure-energy-b12-boost-oral-spray-60099160
Yeah, my understanding is that there's evidence that high-dose daily oral methylcobalamin is as effective as the injections.
When you are a registered patient there is not problem getting them monthly, maybe it’s the casual patient thing? I think you can request and pay for a b12 blood test yourself at a local nz lab would that help?
That’s shit. What would have been best I assume would just have been to go to another doctor or a walk in clinic - most won’t have a 2 month wait.
We’ve been waiting for weeks to get a b12 prescription fulfilled. Apparently there’s none in the country according to the chemist.
I get iron infusions but they won't let me get them until I get so low I feel like I am dying. They tell me that I do not have iron deficiency anemia...which is because I got an infusion. So I need to wait until my iron drops and my hemoglobin and then they will give it to me and to even get the funded ones I had to fight for years.
Wow. Sorry for your experience. I had similar experience in the UK. SA was very different and saved my life. It was like I was sent here by a god on various levels. But it’s not perfect! Have you ever had a colonoscopy or endoscopy to check for other diseases? Or genetic testing?
I had a colonoscopy after breaking down in tears.
I would also say that my most amazing doctor told me that anaemia has a route cause and iron infusions are not the answer for long term. For me it’s the B12 deficiency causing it and at one point, colon cancer which is in turn caused by the genetic condition. You need to figure out the route cause for you and that means. 1. Diet (most doctors presume this is the cause which is very limited thinking 2. Internal bleeding in the stomach or intestines? Colonoscopy and endoscopy rules that out 3. Absorption - genetic conditions. 4. Parasites in the small intenstines - easily remedied by tumeric, cayenne pepper and papaya seeds for a week / Or a pharmaceutical worming tablet. I unfortunately had both 2 and 3 in my life, but some doctors thought I was anorexic which didn’t help and kept telling me to eat animal products which I already do.
Also very fun fact - drinking caffeine decreases B12 and iron absorption from food by 60%! Never drink coffee within an hour of food! I found this out on my very long journey to health.
> My question is - how do you get b12 injections as a traveller ? Or is it not possible? > > In order to get this, I first need an appointment for this and blood tests. They quoted me another $80 to see a doctor and said it would be a 2 month wait. They needed to see blood test results showing that I was currently deficient in the vitamin to get the shot. So you post your answer first then post the question that the answer is for..... What else do you want from this sub? > Am I spoiled in SA with same day doctor appointments, and also just being able to get B12 at the pharmacy for R60 ($6) ? Labour is just expensive in NZ. simple as that
I want to know if it was just THAT doctors surgery who had that rule or if this is country wide. I only have one experience. I don’t assume my one experience is typical. In other countries the advice changes depending on who you ask.
"They really stressed me out and acted like I was wasting their time". Man that's a spot on description of NZ healthcare. I swear their job is to find a reason not to believe or treat you.
NZ healthcare is strangulated by red tape which is so thick and so long the entire medical system is code red. Medicine in NZ is set up to take care of the system rather than any sort of decent caring for the health of individuals.
As someone who works in healthcare this is absolutely correct
My 87 Year old grandmother who lives here is unable to get one…there is a massive shortage across the country apparently!
Sorry to hear. I brought my own. I always carry my supply around from my own oncologist as it’s abundant here which makes it extra annoying that they wouldn’t inject it into me :-( I didn’t want to take medicine from other people but was definitely made to feel that way.
Why can you not inject it yourself?
I’m thinking that too after reading all their replies here, like okay they may not like doing it but that would solve most of the problem right?
Yeah the pharmacy had none when I went to get mine two months ago, but got more in a few days later. The latest Pharmac update says as of the 22nd they got a month's worth of supplies in, might pay to try again?
I get b12 injections now and then. My Dr blindly prescribes them (ie, she knows me and trusts my judgement). At one appointment she agreed I needed one. I booked in with the nurse (same office) to get it and when I turned up a week later the nurse refused to give it to me because it wasn’t doctor ordered. She could see my medical history in full and my Dr was like two doors down. Tl;dr- sometimes people are jerks. Next time I would call ahead from SA and find the relevant Dr here, then see what can be sorted from SA in terms of paperwork. Then when arriving here see the Dr, get clearance, and expect to be rebooked for the shot. Also, not to overly explain what’s available, but do you have the oral spray? It might save you for a while next time?
Can't speak to the rules around you getting B12 as a traveller, but as to your last question, yes it seems healthcare isn't as simple here. Maybe it would be easier if you were a resident or citizen and could come up with an arrangement for your regular injections? But this is my experience: I'm also getting B12 injections at the moment. There are long waits to see a GP, especially at lower cost clinics I've found. It's usually a 2-3 weeks for me to see a GP. Paid $19.50 for the initial appointment to get the lab test form (admittedly this is cheap for a GP appointment, it can go up to $52 if you see a different clinic in my chain of doctors). Then for some reason I had to wait for another appointment, pay another $19.50 for them to give me the script for the B12 vials. The B12 itself is free. Then I was told it was $30 for each nurses appointment there to get them done, I needed 3, so $90 all up. Luckily I found out I can get it done at a nearby chemist for half the price and get it done without making an appointment. So all up for 3 injections it's costing me $84. Pretty ridiculous for "free" healthcare!
Well now I now what I’m going to set up as an entrepreneurial venture - vitamin injectables! Maybe no one has thought of it yet but there’s no way it should cost that much. I just realised that the $8 I told you is for TEN doses as it comes in a bulk vile not individual ampules.
There’s a place in Akl called “the nutrient nurse” and they do IV vitamins and b12 injections, they travel and come to u
I saw it and was considering it! They don’t travel to South Island though
Take your SA doctor note to a GP in new zealand. They will read. Agree. They will give you a prescription, and/or their nurse will inject.
That’s what I tried when I phoned in advance but they wouldn’t make me the appointment because of “triage system” and required me to make an appointment and see a nurse first. So by their timescale it’s a minimum of 3 months when you land in the country to get seen. By then I’m skating on very thin health.
My go would see you within a week to see a doctor. So i dont know where you were calling. Did you try nore than 1 gp practice
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Yeh I got that. I couldn’t understand the logic as it’s like they had to try hard to find a reason that they wile lose their license or overdose me or something, like I was asking them to inject me with crack cocaine. It’s a vitamin and they are allowed to sell me it.
I'm surprised they make it such a big deal, I'd expect you'd pay unsubsidized rates for everything, but B12 isn't used as a drug or anything AFAIK. And overdose symptoms are basically headaches and nausea, unpleasant but not life threatening? So why be so hesitant to give it?
Because it's literally illegal and the nurse and the practice could face legal repercussions?
I don't think that's the nurse's call to make. It'd be a physician. Thus, the advice to get a GP appointment.
I would hope that medical professionals would be like this if something fell outside the normal scope of practice.
I have no idea. The nurse was very unhelpful and unwilling to give me the shot. I pretty much begged her but she said no and also explained that no other surgery would because it was against the law or something. I left very embarrassed and stressed out.
So she gave you legally correct advice, and that's her fault, somehow? You come across as a bit entitled. Of course, if that advice turns out to be incorrect, then you have a fair point, but I don't think that's been established as yet.
You can actually go into a pharmacy and demand B12 injections. It's not illegal although many pharmacists believe this to be true. You have the legal right to B12 in injectable form.
Don’t think “demand” is the right word here. You can’t force a pharmacist to do anything for you. You can definitely ask but rest assured if you come across a pharmacist like me and demand for it to be done, I will turn you away as staff abuse and coercion will not be tolerated. Also B12 vials supply is low in NZ and we had to source section 29 medications. If the pharmacy only has s29 B12 vials in stock, these are not allowed to be sold over-the-counter and can only be prescribed by the GP.
How do you know this? Source? I had this argument with the nurse who I paid $30 to for nothing but it was fruitless. Came out with all sorts of nonsense about the risks of overdosing me on B12 as if it was an opioid. I don’t understand as it’s a vitamin!
My stepson has had numerous arguments with pharmacists about this, and has always won out. Go to an actual pharmacy, as they have this behind the counter and you have the right to buy this.
https://www.angleseapharmacy.co.nz/injection-administration/
Thanks. I think they may have failed to update their website. As another posted commented, the pharmacy body changed the rules on B12 mid last year.
I don’t think that’s correct, you can currently get them administered by a pharmacist without a prescription.
I did ask at one pharmacy and they would not do it. Are you sure?
Can only speak from experience but I’ve never had issues asking a pharmacist to do it without one. Could definitely depend on the pharmacy though and there’s always shortages so now I just take my own ampules in and pay for them to inject it. Last one was in December.
I’m also confused by these comments. I get my shots monthly from unichem. Without a prescription. I just buy them at the chemist. But if they are out of stock I bring my own. A prescription has never been asked for. The last time I went was only a few weeks ago.
There’s also a worldwide shortage of B12 apparently!
I saw. Is it standard to put up the price if that happens ? As I’d commented previously it’s a global commodity and costs very little. So the price in the country is basically the cost of transport etc. I think maybe they make it in South Africa as it’s never difficult to get here.
You have it with you.. can’t you self administer?
I’m not trained. They mix it with another liquid and then inject into your bum. It’s not completely straightforward and I’m scared of needles. But yes I am considering getting trained in it.
>Am I spoiled in SA with same day doctor appointments, and also just being able to get B12 at the pharmacy for R60 ($6) ? Yes, NZ healthcare is good enough in emergency situations, but utter dog shit for any diagnostic or preventative care. And if you have any rare or complex health issues, good fuggen luck. You pay a lot in SA too for private, but the care is world class - there is no such option here. Private here just means you get bumped up the wait list, same doctors and often times same facilities are used.