The optimal number of PHO's is zero. The End.
I am a GP. I am an urgent care dr. I am a DHB elected board member. I am a Police dr. I am a locum. I am a Mum. I am a occasional charity worker, whether medicine or school.
I have yet to see a PHO do anything that couldnt be done by primarycare without them clipping the ticket.
In military terms, we are frontline specialforces; they are the quartermasters at home divvying up the buns. How few buns make it through to the frontline. How fat the quartermasters grow.
It seems increasingly obvious that the only ones fighting to keep PHOs alive are those directly benefit from them.
All the while the PHOs scream they represent General Practice whilst General Practice scream equally loudly that they don't. Increasingly it's like something out of Monty Python, even the Federation is akin to the final crucifixion scene "I'm Brian and so is my wife", "despite what General Practice says, we represent them".
In the words of that iconic philosopher Steve Hansen - flush the dunny and move on.
New Zealand Doctor