By Hayley Redpath
Change is in the air as Primary Health Organisations absorb new recommendations that might spell the end for some.
Earlier this month Health Minister Tony Ryall released a review of the New Zealand health system called Meeting the Challenge. It had a number of ramifications for Primary Health Organisations and according to some marks the beginning of the most significant health reforms since the establishment of District Health Boards in 2001.
The report made 170 recommendations for change in its aim to improve the population’s health, enhance the patient experience of care, and control per capita health care costs.
As summarised by Buddle Findlay, key recommendations for primary health organisations in the MRG or Horn report were:
the role of PHOs is “to do more to keep people well; reduce avoidable hospital admissions and unplanned readmissions; to take responsibility for shifting services from secondary to primary settings when sensible; and to reduce unnecessary GP referrals”. PHOs that are not successfully meeting these requirements within three years would be reviewed “with a view to removing them”
In the interim reduce management payments to PHOs with less than 40,000 enrolled patients, and use the savings to help them transition to a stronger configuration by, for example, amalgamating with other PHOs (with a suggestion that PHO populations of between 100,000 and 500,000 are required in order to achieve financial efficiency)
scaling back the current PHO Performance Programme, and accelerating the introduction of quality improvement processes, based on the Quality and Information for General Practitioners project (QI4GP)
New contracting arrangements between PHOs and DHBs are proposed, with stronger financial incentives for risk sharing, particularly in relation to chronic conditions and acute hospital demand.
Turanganui Primary Health Organisation has around 32,000 enrolled patients. Chief Executive Keriana Brooking said the MRG recommendations could lead to an overhaul of the current system, but for now, it was business as usual.
“As CEO I am neither excited, nor worried. Instead we are just getting on with the job in an environment of change.”
Keriana reminded readers that Turanganui PHO was one of the first established PHO’s in the country because the people involved recognized that change can be good. “We don’t see anything in the MRG report that we couldn’t work with.”
She added that even before the MRG report came out, Turanganui PHO and its owners have been talking about what it can do differently, and how it can improve levels of service for the community.
Keriana, representatives from Pinnacle, Maori health providers across the Midland network, and other PHO Chief Executives are meeting next week to further discuss the MRG recommendations.