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What is a Primary Health Organisation (PHO)?
Primary Health Organisations (PHOs) are a new type of health care service. PHOs give people in the community more input into the sort of health services they can access, and make sure that different health services work together more efficiently.
In each PHO, experts like doctors, nurses, counsellors, pharmacists, health promoters and others work closely with the community, and with each other. They share ideas and skills to give patients the best care possible. Sometimes being part of a PHO means they can charge lower fees.
Each PHO is run by a Board which includes both professional health workers and people from the community. These community representatives help to make sure that the services provided by the PHO meet the needs of the people in the community. If you want to get involved in this decision making process, talk to someone from your PHO or your family doctor/nurse and they can tell you how to get involved.
Joining a PHO as a patient is even easier. If you visit a family doctor regularly then when they join a PHO you are automatically enrolled in that PHO. Check with your family doctor if you are not sure whether they are in a PHO.
The area which Capital & Coast District Health Board is responsible for has five PHOs, and work is underway to create a sixth PHO for Pacific people.
The seven existing PHOs in this area are:
What can I expect from a PHO?
Within a PHO the health services (GP clinics, health centres, pharmacies, physiotherapy centres etc) will continue to function as they have in the past. However, because the services are part of a PHO they will be expected, over time, to become more responsive to the needs of the people using the service and to the needs of the community as a whole.
PHOs will allow a range of health professionals and other services to provide higher quality care for individuals, families and communities. This may, for example, include social services, midwifery, dentistry as part of a PHO in the future if that is what the community needs.
Iwi can expect an active working relationship with all PHOs in accordance with the principles of the Treaty of Waitangi. This includes iwi and Maori community participation in governance and in service design, delivery and evaluation. In some areas iwi and Maori communities are leading the development of PHOs.
PHOs are expected to provide continuity of service delivery over time and co-ordination across the health sector for enrolled people. PHOs will work with DHBs and communities to make progress on the 13 priority health objectives of the NZ Health Strategy.
How will PHOs be funded?
The government has provided an extra $410 million for primary health care over 3 years, 2002-2005. For PHOs serving populations with a high proportion of Maori, Pacific and low income people, the extra funding will allow this to happen quickly and allow services to be delivered in different ways to suits the needs of different communities and families.
Over the next 2 years, additional funding will be provided to lower fees and provide extra services to people over 65 years and under 18. The government has stated that, over the next 8-10 years, it intends giving everyone in New Zealand better access to quality primary health care services that are either free or low cost.
What will it mean to me as someone using health services?
People using current health services (general practitioners and other primary health care services) will be asked to enrol with that service as their primary provider. This is because the service will be paid according to the people enrolled with it. You can still use other services but you have to decide which is your ‘usual’ primary care provider.
Everyone will be encouraged to enrol with a primary health care provider whether they need to use that service right away or not. This means that PHOs can plan the services around the needs of the whole population, not just those people who come to the clinics and general practices.
General practitioners remain an essential part of primary care services but with the new funding and the way it is paid, there will be more opportunity to use the skills of nurses, community workers, pharmacists, physiotherapists and many other health professionals and social agencies to assist people with health problems.
It also means that more funding and energy will be focussed on keeping people well, prevention of disease, healthier communities, preventing injury, working with schools, healthy housing etc.
How can I have a say about what I want in a PHO?
You can join in discussions about PHOs by attending public meetings about PHOs or by talking with the primary health care service that you attend now. Ideas and opinions can be shared with your representatives on the District Health Board.There are 3 ways that you can be involved in a PHO.
If you would like to be involved in the governance, you can make this known to the groups organising PHOs in your area.
Most people will not want to be involved in governance and policy but have good ideas about the way services are delivered, new services that would be helpful and ideas for improving the communities health. You can become involved in the design of a PHO as PHOs are being formed by putting forward these ideas to existing primary health care service providers, iwi, community groups (such as Healthlinks, consumer groups etc) or DHB members.
Once PHOs are set up, they are obliged to get comment and feedback from people using them about how they are working, what ideas people have to improve services. This will be another opportunity to have your views heard. There will be community representation in the governance of PHOs so there will be community people you can talk to about your needs or ideas and staff and managers will also be needing to know your views to ensure their services are successful.
For more detailed information about PHOs, visit the Ministry of Health website.