Primary Health Care Strategy


Information about New Zealand's Health Strategy


  • What is the Primary Health Care Strategy?What is a Primary Health Organisation?How is a PHO different?Why the change?What are Access and Interim PHOs and what's the difference?

    What is the Primary Health Care Strategy?

    • PHOs will aim to improve and maintain the health of their populations and restore people's health when they are unwell. They will provide at least a minimum set of essential population-based and personal first-line services
    • PHOs will be required to work with those groups in their populations (for example, Maori, Pacific and lower income groups) that have poor health or are missing out on services to address their needs
    • PHOs must demonstrate that they are working with other providers within their regions to ensure that services are co-ordinated around the needs of their enrolled populations
    • PHOs will receive most of their funding through a population needs-based formula
    • PHOs will enrol people through primary providers using consistent standards and rules
    • PHOs must demonstrate that their communities, iwi and consumers are involved in their governing processes and that the PHO is responsive to its community
    • PHOs must demonstrate how all their providers and practitioners can influence the organisation's decision-making
    • PHOs are to be not-for-profit bodies with full and open accountability for the use of public funds and the quality and effectiveness

    How is a PHO different?
    As well as being cheaper if you are in a high needs area, you should notice a couple of other big differences. The first is that the PHO doesn't want to see you only when you get sick and need to see a doctor or go to hospital. It actively tries to keep you well and/or treat you early in your sickness. The second is that there will be a range of people looking after those enrolled with a PHO. You might see a nurse-practitioner, a Maori health worker if you are Maori, a Pacific health worker if you are a Pacific person, a community health worker, a dietitian – and/or you might see a doctor.  The way PHOs are set up also gives the community a chance to influence their decisions. All PHOs have to have a 'board of directors', which includes people from the community.

    Why the change?
    Because too many New Zealanders weren't getting primary health care – that's care outside the hospital. Those countries around the world with the healthiest people are all countries with good primary health care. In those counties people live longer, are healthier and the cost of health care to the government is lower. This is especially the case for some groups of our population who are dying earlier, getting more diseases such as diabetes and cancer, and ending up in hospital for problems that could have been helped earlier.

    What are Access and Interim PHOs and what's the difference?
    From 1 July 2004 almost two million people who belong to a PHO are able to get low costs or reduced fees when they visit their PHO family doctor.

    Over the next few years the Government will be increasing funding to PHOs and, in return, PHO doctor practices will reduce their charges. This has already happened for those PHOs serving the populations that have the worst health. In these PHOs - called Access PHOs and covering one million people, everyone who is enrolled is charged low fees regardless of whether they have a Community Services Card - children under six years old are usually free, older children pay around $10 and adults pay around $15 to $26.

    Other PHOs are called Interim PHOs. Until there is enough funding for all PHOs to be on the Access funding formula, an Interim formula will apply to other PHOs/practices. The Interim formula will continue to use the Community Services Card for determining funding and setting patient fees for people outside the 6 - 17 and 65 and over age groups. It includes additional funding for a range of new functions such as health promotion and extra services to improve access for high-need groups.

    As Government funding allows, the per capita amounts in the Interim formula will be increased towards the levels in the Access formula. This has already begun with Interim PHOs getting more money to reduce doctors fees and prescription charges for 6 to 17 year olds and for people aged 65 years and over who are enrolled with them.

    Cheaper doctors' visits and cheaper prescriptions will be rolled out in the next three years.

    The Primary Health Care Strategy was launched in February 2001 by Health Minister Annette King. It builds on the population health focus and the objectives of the New Zealand Health Strategy, the New Zealand Disability Strategy and outlines how a different approach to primary health care will improve the health of all New Zealanders through: a greater emphasis on population health, health promotion and preventative care; community involvement; involving a range of professionals and encouraging multidisciplinary approaches to decision-making; improving accessibility, affordability and appropriateness of services; improving co-ordination and continuity of care; providing and funding services according to the population's needs as opposed to fee for services when people are unwell.

    What is a Primary Health Organisation?
    A PHO is a group of providers whose job it is to look after all the people enrolled with them. The group will always include a GP and may also include some or all of nurses, Maori providers, Pacific providers, pharmacists, dieticians, mental health workers, community health workers and dentists - often working in teams.

    PHOs are the local provider organisations through which District Health Boards (DHBs) will implement the Primary Health Care Strategy. The essential features of PHOs are set out in the Minimum Requirements released by the Minister in November 2001:
14/08/2009 3:19 p.m.
Desiree Edwards