Media release from Victoria University

Some recent reports show good progress is being made with recent primary health care reforms in New Zealand, but there are still challenges ahead.

Four reports, released today by Victoria University's Health Services Research Centre, focus on the activities of general medical practices, issues relating to patient fees, and the development and roles of Primary Health Organisations (PHOs) in the reformed primary health care system.

"Major reforms in New Zealand's primary health care sector over recent years have led to significant increases in funding, reductions in the fees patients pay when they use services, and increases in consultation rates, including with nurses," notes lead researcher Dr Jacqueline Cumming, "but these reports focus on some of the key issues we still need to sort out if we are to make further gains in improving our primary health care services.

"Overall, we continue to find support for the recent reforms, but some of the individual changes are not so well supported. There also continue to be different views about future directions for primary health care in New Zealand, for example over whether we should have universal or a targeted funding for primary health care, and about the roles and responsibilities of PHOs.

"PHOs were generally able to set themselves up as they wished, and not surprisingly we now have a diverse range of PHOs in New Zealand, with diversity in how they see their roles, how their boards are established, whether or not board members get paid, and how they work with their local communities and provider organisations."

Overall, the researchers suggest that good progress has been made in strengthening New Zealand's primary health care system, but there is a need to stand back and examine where to go to next (for example in relation to the roles and capacity of PHOs) and how to manage the relationship between the state and general practice in New Zealand.

"We also need to recognise the diversity in primary health care planning and delivery that exists around New Zealand, and this suggests a 'one-size-fits-all' approach is unlikely to work, requiring DHBs and PHOs to work together to identify what will work best in each district."