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Ministry of Health welcomes PHO feedback

Ministry of Health welcomes feedback from Primary Health Organisations (PHOs)

An independent report looking at primary health organisations' (PHOs) first year has constructive criticism that will help shape future improvements, the Ministry of Health said today.

Director-General of Health Dr Karen Poutasi said the report, commissioned by the Ministry of Health and the Health Research Council, was prepared from the PHO perspective and highlights important issues they have faced during the first year of implementing the Primary Health Care Strategy.

``It confirms some information we had from the sector and adds to our understanding of various PHO concerns that we've been working on for some time. This is important because it will help us work with the sector to address the implementation challenges they are facing,'' she said.

``A significant number of these concerns have been addressed by the Ministry and district health boards and it's worth noting that this is a collaborative process -- we recognise there is no one-size-fits-all solution that will work for New Zealand's diverse range of communities. So we've deliberately kept a degree of flexibility in the PHO environment to encourage different arrangements around the country and give local communities a chance to contribute.

``The primary health care sector in New Zealand is going through the biggest change since World War Two and it is inevitable that in the very first year of implementing this change there will be difficulties. This first step in the evaluation, which covers the initial 12 months of setting up 34 PHOs, reflects some of these early issues.''

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Dr Poutasi said it was pleasing to see there was widespread support for the philosophy behind the formation of PHOs, despite implementation difficulties in the first year.

``The report shows that PHOs recognise their own long-term potential and that of the Primary Health Care Strategy. It also shows the sector is willing to make it work so we can get the overall health gains we need for all New Zealanders to have a better quality of life,'' she said.

``The Ministry is committed to the strategy and finding ways for the sector to work together to achieve its full potential. To help us do this, we're establishing a taskforce with representatives from the sector who will advise on PHO implementation as we step forward. We're working to identify members of this group before Christmas so it can have its first meeting in the new year.

``Ongoing quality improvement is essential as we move forward with PHO implementation. We're looking for where opportunities exist to further improve systems and processes that support PHOs.''

Dr Poutasi said an example of this is the development of a public awareness campaign which began last month with posters and leaflets being distributed to every PHO practice and clinic in the country.

``Obviously we want all New Zealanders to know about the benefits of enrolling with a PHO and we have ongoing plans to raise this sort of public awareness.''

Seven months ago, when work on the report began, about one million New Zealanders were covered by PHOs, with 700,000 of them able to get a much broader range of primary health care services at an affordable cost.

There are now 53 PHOs around the country servicing more than two million people, and more than one in four New Zealanders have access to low-cost primary health care.

The report, Primary Health Organisations: The first year (July 2002 ? June 2003) from the PHO perspective was prepared by Victoria University's Health Services Research Centre (HSRC) and was funded by the Ministry as part of the Health Reforms 2001 project.

Dr Poutasi said the report would provide rich baseline information for the evaluation of the implementation and intermediate outcomes of the Primary Health Care Strategy. This will also be led by the HSRC.

The evaluation has a strong formative component that will feed-back important developments to key stakeholders during its lifetime. The first full report is due in June 2004. In addition, there will be more regular meetings between the evaluation team and the Ministry at which new and ongoing issues will be identified. The first of these will be early next year.


Recent developments aimed at improving the PHO environment include: Public awareness campaign The release last month of PHO resources -- posters, leaflets and factsheet; Distribution of local PHO stories to community newspapers to lift the PHO public profile; Establishment of an 0800 call centre number for people looking for more information on PHOs planned for early 2004; Radio advertising in January to promote the 0800 number; Work on a medium to long-term public awareness raising campaign, including market research into public perceptions. Funding The announcement last month of an increase in management fees for small to medium-sized PHOs. This benefits all PHOs with fewer than 75,000 enrollees; >From 1 October 2003, more Government money became available to begin smoothing out funding differences between Access and Interim PHOs. This means all PHOs can now offer enrolled youngsters aged between six and 17 years reduced fees. There has also been an acceleration by the Government of a $47 million nationwide initiative to make primary health care more affordable for older New Zealanders enrolled in PHOs. >From 1 July 2004 all New Zealanders aged 65 years and older who are enrolled in PHOs will be eligible for low or reduced patient fees and $3 prescription items; A 12-month initiative for those Access PHOs and Access practices experiencing financial hardship since becoming part of a PHO. DHBs decide on a case-by-case basis whether top-up funding is needed to bring providers up to their pre-PHO levels while they stabilise in the PHO environment; >From 1 April 2004 people enrolled in Access PHOs and children aged 6-17 enrolled in any PHO will be able to get prescriptions for $3 per item; The piloting of the Care Plus initiative that gives extra funding for another group of New Zealanders with high health needs. Technical issues The release in early October of the Ministry of Health-sponsored Counties Manukau Enrolment and Capitation Based Funding (CBF) Process Improvement Project Report. The report was developed with the PHOs in the region and has 33 recommendations to improve PHO enrolment processes. Work to implement many of these recommendations has already begun. To view the report, go to:; The latest version (Version 16.1) of the PHO Service Agreement includes a cap on the number of casual claims that can be deducted from a PHO for casual services provided to one of their enrolled patients who gets services elsewhere. This is capped at three consultations each month for each individual patient; An agreement between the Government and GP groups on how to set patient fees.

The HSRC report is available on under publications, new reports

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