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The Future Shape of Primary Health Care

27 September 2000

The Future Shape of Primary Health Care - analysis of discussion document complete.

THE path for primary health care is now being finalised on the basis of nearly 300 submissions received in response to the discussion document: The Future Shape of Primary Health Care.

The Primary Health Care Strategy, which comes under the umbrella of the New Zealand Health Strategy, will set the framework for a population focused health and disability sector at the primary health care level - the level where most people first come into contact with the health system. It is expected to be released by the Government later this year.

Ministry Senior Advisor Dr John Marwick said he was very pleased with the level of response. Submissions were generally favourable to the envisaged path for primary health care. A 20-page submission summary document is now publicly available.

"There were some very substantial papers submitted. I'm grateful for the hard work that people have put in and for the many constructive ideas," he said.

"The comments have especially helped in areas where we needed help with which approach would work best. We are using those now to develop the final strategy."

A total of four thousand, five hundred copies of the discussion document were distributed during the consultation period. The document was also available on the web.

Two-thirds of the submissions were from groups and individuals who provide primary and other health care services. These included organisations such as the College of Nurses, the Pharmaceutical Guild and the New Zealand Medical Association, GP groups such as Independent Practicitioner Associations (IPAs) and general practices, community based providers, other providers such as midwives

The other one-third of respondents came from individual consumers or groups representing them. These groups included community health groups, health support and advocacy groups, academics and Territorial Local Authorities.

The discussion document set out a broad vision for primary health care and around three-quarters of the reponses either explicitly or implicitly supported aspects of this view.

Some of the proposals for how the vision would be achieved were debated more than others. These included: the structure of the primary care organisations (PCOs), a concern that District Health Boards might be dominated by hospital services leaving primary and community healthcare to suffer, concerns over how funds would be allocated, and the mechanics of affliation with GPs and whether this would narrow people's choices.

Dr Marwick said respondents identified a number of advantages in adopting the new vision for primary health care. The vision recognises that primary health care must be central to achieving the Government's goals of closing the gaps in health and better health and health services for all. The plan is for people to affiliate with a primary health care organisation that will be linked to the District Health Boards (DHBs). The Strategy will:

improve access to primary health care services when they are needed; increase services aimed at Maori and Pacific people; strengthen continuity of care without reducing people's choices; put greater emphasis on co-ordination between health services; and focus on population-based services (working with the community to keep people well and out of hospital).

General comments were also received on the changes to the structure of the health care system. These included:

approval that the system would be less commercially focused; that the election of board members to the DHBs is a way of ensuring boards are more responsive to the needs of the community; a high level of support for the use of population based funding that fairly reflects the needs of those served.

Over 45 responses, most from health providers or national organisations, highlighted quality as an important aspect of service provision. More than half these submissions noted that accreditation was an essential part of ensuring quality. Other methods of ensuring quality were also noted including: bench-marking, peer assessment and developing quality focused organisations.

Consumers and providers both commented that it was important that the quality of services provided by primary care organisations and other providers to be monitored. A variety of methods were suggested such as customer satisfaction surveys and including consumers in any assessment of quality.

Dr Marwick said work to finalise the Primary Health Care Strategy can now proceed and is expected to be completed by the end of the year.


The 20-page summary of the responses has been prepared and is available either in hard copy or from the Ministry's website.

For further information contact; Sue McCabe, Media Advisor, 04 496 2067 Internet Address;

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