Health Minister Annette King today signalled a bold new approach to primary health care in New Zealand.

Launching the primary health care discussion paper, The Future Shape Of Primary Health Care, Mrs King said the Government was rejecting the move toward competing, profit-seeking primary care providers owned by off-shore insurance companies.

The paper, a key element in the development of the New Zealand Health Strategy, will be open to submissions from health care workers, communities and interested individuals and groups until May 26, and the Ministry of Health will report back to Mrs King on the submissions in June.

"I urge people to take this opportunity to contribute toward building a better primary health care system. All New Zealanders should have access to good primary health care when they need it. We need to put more emphasis on helping them improve their health, on preventing disease, supporting self-care and offering assistance to those with ongoing problems.

"Every day 50,000 children and adults receive advice, treatment and care from primary health practitioners. The challenge is to ensure they all receive the same quality of advice, treatment and care, and that we reach those now falling through cracks in the system."

Mrs King said some areas of New Zealand, such as South Auckland, Northland and East Cape, clearly needed greater investment in primary health care. "The basic principle of primary health care must be that public resources are distributed differentially across the country according to the needs of the population."

The discussion paper proposes that patients affiliate with a primary care organisation that will be linked to the district health boards, to be established later this year when the Public Health Services Bill is passed.

The primary care organisations, which will take responsibility for ensuring patients receive the information and care they need, would evolve progressively, Mrs King said. The organisations would be characterised by community participation and an ethic of teamwork, not competitiveness.

Mrs King said the paper also proposed a far stronger population focus for primary health care providers. "District health boards will be responsible for undertaking population needs assessments in their own areas. Population-based funding must be sufficiently sensitive to variations in local conditions to meet the extra needs of people living in areas of higher deprivation."

Mrs King said the new primary care strategy was particularly concerned to deal with disparities in the health status of Maori and Pacific people, and would also seek to provide a consistent level of care in rural areas.

"Maori approaches to health reflect two key ideas: keeping people well, and recognising there are a number of factors that affect the wellbeing of an individual or group. The health of whanau, hapu and iwi are crucial to the future of Maori development. The impact of socio-economic, cultural and lifestyle factors can affect the operation and health of whanau positively or negatively.

"We must seek to enhance and affirm whanau wellbeing as a pivotal force in the lives of Maori."

Mrs King said it was essential, to improve the health status of New Zealanders, that there was more coordination between health services and other sectors such as education, housing, justice and welfare. The district health boards would play a key role in assisting this coordination.

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