GPNZ Health Reforms
General Practice New Zealand (GPNZ) has welcomed today’s announcement of major reforms designed to create a more equitable and fit for purpose national health system.
GPNZ Chair and Karori GP Dr Jeff Lowe said: ‘There are no surprises in the overall direction. Shifting the focus of our health system to keeping people well and out of hospitals and not just caring for them when they get sick is essential.’
‘This is a tremendous opportunity to deliver better primary and community care services that will be better resourced, better co-ordinated and better designed with and for the people they serve.’
GPNZ supports moves to improve health equity and to ensure Te tiriti o Waitangi underpins all aspects of planning and delivery of health service, with the creation of a Māori Health Authority with commissioning functions sitting alongside Health New Zealand.
Dr Lowe said: ‘Our health system struggles with persistent inequity and we need to do much more to improve the health of Māori and Pacific communities who continue to have higher rates of disease and mortality and poorer outcomes and access to care. There are numerous initiatives across the country that are improving access, quality of care and outcomes for people, particularly in our Māori and Pacific communities, and for people living with complex and long term conditions. These reforms must build on those.’
GPNZ particularly endorses plans for the development of localities responsible for commissioning and delivering a range of integrated services, designed around population health needs.
‘Collaborative local health networks are emerging already in many parts of the country and one of the most exciting opportunities these reforms offer, is the potential to scale and develop those nationally across Aotearoa. This could mean offering convenient access to face-to-face and virtual primary health care with seamless connection to a range of services including allied health, diagnostics, social and community support and specialist consultations,’ says Lowe.
While there are still many details to work through as the reforms are implemented, one of the major unknowns is the future of funding levels to ensure that people can access the care they need when they need it.
‘We still need a funding review of general practice,’ says Lowe. ‘The need for a new general practice funding model drove the initial review of the health system but we’re still no further fowrard. As well as ensuring primary and community funding care is ringfenced and weighted to include ethnicity and deprivation, GPNZ wants to see funding mechanisms that also prioritise health promotion and addressing health inequities.’
With major and rapid organisational change imminent, Dr Lowe pointed out that one of the greatest challenges will be achieving the culture change needed to avoid getting stuck in thinking about existing organisations and structures.
‘We need a major culture change within structures and incentives that support collaboration rather than competition, creating a platform for stronger local relationships and improved flexibility and innovation in the way care is delivered. The success of these reforms isn’t in how we establish new national institutions and regional structures but how we ensure everyone in New Zealand can access fair, convenient and high-quality health care that’s relevant to them.’
GPNZ will be working with its members and the transition unit to shape the next steps in implementing the reforms, ensuring that it builds on existing good practice.
‘GPNZ’s recent stocktake of services provided by PHOs in primary care - where most people access their health care - highlights just how much goes on in primary care every day and the depth and diversity of services being provided to meet the needs of local communities, from healthy eating and exercise programmes to co-ordination of COVID-19 testing.
‘Whether it’s developing a new care pathway to speed up access to treatment, or providing a mobile clinical team to bring care to hard to reach whānau, the common factor is how services are designed and developed with a deep understanding of people’s needs and strong partnership with local iwi and communities.’
“We are well placed to make the transformation we’ve talked about for a generation. The services are still desperately needed and the work is not going away,’ he says. ‘The solutions are already in the system and the buy in is there.’