Primary Health Care in New Zealand

The Ministry of Health is the government’s primary agent in New Zealand’s Health and disability system, and has overall responsibility for the management and development of this system.
District Health Boards

Health services for each district are funded by the Ministry of Health through a District Health Board (DHB). There are 20 DHBs across New Zealand each are governed by a board – elections are held every three years with the Chairperson being appointed by the Minister of Health. The government funds each DHB using taxation dollars.

The Canterbury DHB collaborates with the Canterbury Health System  and our community to collaboratively decide what health and disability services are needed and how to best use the funding we receive from Government to improve, promote and protect the health, wellbeing and independence of our population.

New Zealand’s founding document, the Te Tiriti O Waitangi (Treaty of Waitangi) agrees to a partnership commitment  between Māori and the Crown. In the New Zealand Health Strategy, district health boards are expected to form effective partnerships at all levels under the Treaty of Waitangi and to identify ways they can respond to the needs of Māori  in an equitable manner and support Māori health services. As a starting point, it is suggested that DHBs formalise a relationship with Mana Whenua in their region. In Canterbury, the Mana whenua ki Waitaha is Ngāi Tahu.

Primary Health Organisations

Primary Health Organisations (PHOs) are funded by DHBs to support the provision of essential primary health care services through general practice to those people who are enrolled with the PHO. PHO core functions are:

  • Delivering vital primary healthcare services via general practice
  • Reducing the level of preventable illness
  • Improving access to healthcare
  • Providing extra assistance to those with high health needs.

Almost all general practices in Canterbury are aligned with one of these PHOs:

  • Christchurch PHO
  • Rural Canterbury PHO
  • Pegasus Health .

PHOs receive money from the Ministry of Health for each person enrolled. The Ministry estimates how many times each person will visit a general practice team to determine how much funding to provide. This funding is called First Level Services, or ‘capitation’, since it is based on payments per capita (per head). Of course, some people will visit their general practice teams more frequently than expected, while others will not go at all.

Funding allows PHOs to:

  • Subsidise doctor’s visits
  • Reduce prescription costs
  • Run health promotion programmes
  • Develop innovative ways of improving the uptake of services to reduce health inequities and inequalities in their populations
  • Coordinate health promotion activities
  • Improve access to health services
  • Subsidise care for the chronically ill
  • Retain a sustainable rural health care workforce
  • Allow GPs reasonable after-hours rosters.

The actual amount of funding received is recalculated every quarter based on changes in population. More than 75% of the money we receive each year is spent on First Level Services, i.e., subsidising visits to General Practice teams. The remainder is used for health promotion, ensuring specific communities have access to the services they need, as well as for general administration.

General Practice

New Zealand GPs and Nurse Practitioners (NPs) provide community-based primary health care. Day-to-day work as a Pegasus Health GP or NP includes first contact, diagnosis, and management, continuity of care, health promotion, prevention and screening. General practices in New Zealand are predominately  private businesses or in some cases owned by community trusts with some services subsidised by the government. Patients usually pay a contribution to see a GP or NP. If possible, patients in New Zealand are encouraged to enrol with a general practitioner or nurse practitioner and to see the same GP or NP each time they visit.

In Christchurch there are several after-hours clinics available as a preferred alternative to the Emergency Department. Pegasus Health’s 24 Hour Surgery is a well-resourced 24-hour acute care facility staffed by a permanent team of doctors and nurses, mixed with a roster of local GPs.

PHARMAC

The Pharmaceutical Management Agency of New Zealand (PHARMAC) selects which medications will be subsidised in New Zealand. There are about 2,000 medications on the national register which are either fully or partly subsidised.

Ambulance Services

The charitable organisation St John Ambulance provides most of the ambulance services, both emergency and non-urgent, across the country. Depending on the reason for transporting a patient this may incur a partial charge to the patient.

General Practice Medical Discipline Bodies

The Medical Council of New Zealand is the regulatory body for doctors and produces resources which you may find useful. We suggest you visit the Medical Council of New Zealand (MCNZ) website to obtain a copy of:

  • Cole’s Medical Practice in New Zealand
  • Good Medical Practice

GP experience in these countries is recognised by the Royal New Zealand College of General Practitioners as comparable:

  • Australia
  • Belgium
  • Canada
  • Hong Kong
  • Ireland
  • The Netherlands
  • Singapore
  • United Kingdom
  • USA

Nursing Council

The Nursing Council of New Zealand is the regulatory authority which registers nurses. Nurses are registered as competent and fit to practice in order to protect the health and safety of the public. The Council’s role is defined in the Health Practitioner’s Competence Assurance Act 2003.

GPNZ

General Practice New Zealand (GPNZ) is an organisation with government and health system relationships. Their governance and executive leadership expertise is drawn from member networks and reflects doctors, nurses, managers and others working in partnership for the benefit of all New Zealanders and the health system as a whole.

Their sixteen member networks represent approximately 2,000 General Practitioners and 2,000 Practice Nurses providing health care services to over 2.3 million New Zealanders from 800 general practice locations.

Community Providers

Non-Government Organisations (NGOs) provide a wide range of support services to the communities in which they operate. Community nursing providers in Canterbury include Nurse Maude, Access New Zealand, and Healthcare NZ.