The Primary Health Care StrategyFull text version
Date of publication: February 2001page 2 of 14 This is the full text online version of this document.
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The Strategy in Summary
Primary Health Care in the New Health and Disability System
A strong primary health care system is central to improving the health of New Zealanders and, in particular, tackling inequalities in health.
This Strategy provides a clear direction for the future development of primary health care so that it can play this central role within the new health system. There is evidence available about the specific contribution primary health care can make to improved health outcomes which has informed the new direction.
This Strategy follows on from the New Zealand Health Strategy and the New Zealand Disability Strategy. The New Zealand Health Strategy sets out principles, goals and objectives for the health system – and these have guided the development of the Primary Health Care Strategy. The New Zealand Disability Strategy, which is still being developed, has also helped shape this Strategy.
The Vision, Key Directions and the Population Approach
Over five to ten years a new vision will be achieved:
People will be part of local primary health care services that improve their health, keep them well, are easy to get to and co-ordinate their ongoing care.
Primary health care services will focus on better health for a population, and actively work to reduce health inequalities between different groups.
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This vision involves a new direction for primary health care with a greater emphasis on population health and the role of the community, health promotion and preventive care, the need to involve a range of professionals, and the advantages of funding based on population needs rather than fees for service.
Six key directions for primary health care will achieve this vision:
- work with local communities and enrolled populations
- identify and remove health inequalities
- offer access to comprehensive services to improve, maintain and restore people’s health
- co-ordinate care across service areas
- develop the primary health care workforce
- continuously improve quality using good information.
New Arrangements for Primary Health Care
The New Zealand Public Health and Disability Act 2000 gives District Health Boards overall responsibility for assessing the health and disability needs of communities in their regions, and managing resources and service delivery to best meet those needs. Twenty-one District Health Boards are supported by the Ministry of Health, which is the national policy advice, regulating, funding and monitoring agency. This Primary Health Care Strategy will guide District Health Boards and the sector to achieve health and independence gains through primary health care.
The vision and the new directions will involve moving to a system where services are organised around the needs of a defined group of people. Primary Health Organisations will be the local structures to achieve this. People will be encouraged to join a Primary Health Organisation by enrolling with a provider1 of primary health care services such as a general practice or local health clinic. District Health Boards will work through Primary Health Organisations to achieve health goals locally.
Key points about Primary Health Organisations are as follows:
- They will be funded by District Health Boards for the provision of a set of essential primary health care services to those people who are enrolled.
- At a minimum, these services will include approaches directed towards improving and maintaining the health of the population, as well as first-line services to restore people’s health when they are unwell.
- Primary Health Organisations will be expected to involve their communities in their governing processes.
- All providers and practitioners must be involved in the organisation’s decision-making, rather than one group being dominant.
- Primary Health Organisations will be not-for-profit bodies and will be required to be fully and openly accountable for all public funds that they receive.
- While primary health care practitioners will be encouraged to join Primary Health Organisations, membership will be voluntary.
Implementing the Primary Health Care Strategy
The Strategy will evolve over the next few years and may not be fully realised for five to ten years. During this transition there will be flexibility about how new initiatives develop, and tolerance of short-term teething problems. Key priorities for early action are:
- reducing the barriers, particularly financial barriers, for the groups with the greatest health need, both in terms of additional services to improve health, and to improve access to first-contact services
- supporting the development of Primary Health Organisations that work with enrolled populations
- encouraging developments that emphasise multi-disciplinary approaches to services and decision-making
- supporting the development of services by Maori and Pacific providers
- facilitating a smooth transition to widespread enrolment of Primary Health Organisations through a public information and education campaign to explain enrolment and promote its benefits for communities.
The Strategy outlines a new vision for primary health care. It does not contain details of implementation, which will involve evolutionary change to protect the gains already made. Involvement and collaboration with the primary health care sector will be a key feature of the implementation process in the coming months and years. This is crucial to ensure that all issues are considered in developing the new arrangements.
To achieve this involvement, working parties of providers, communities, District Health Boards, and the Ministry of Health will be formed around key areas of work. Consideration may also be given to developing a primary health care advisory group to help guide developments in the sector.
1 In this Strategy, ‘provider’ is used for any entity that provides health services, and ‘practitioner’ is used for an individual who provides health services.
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