Vision: Quality and Innovation in Primary Health Care
Purpose: Empower and Enable our People to Thrive
Frequently Asked Questions
- What is a Primary Health Organisation (PHO) ?
- Why is all this necessary?
- What do I do if I have a problem with my doctor or PHO?
- Can I consult another doctor?
- What if I have to see my doctor regularly because of a chronic condition?
- Can I belong to more than one GP and PHO?
- How do I know if I am enrolled in a PHO?
- How do I join a PHO ?
- What are the benefits of belonging to a PHO ?
PHOs are the local structures for delivering and co-coordinating primary health care services. PHOs bring together GPs, nurses and other health professionals (such as Maori health workers, health promotion workers, dieticians, pharmacists, physiotherapists, psychologists and midwives) in the community to serve the needs of their enrolled populations. Most GPs belong to a PHO
PHOs vary widely in size and structure and are not-for-profit. The first PHOs were established in July 2002 and there are now 81 PHOs around the country. DHBs worked with local communities and provider organisations to establish PHOs in their regions.
PHOs get a set amount of funding from the government to subsidise a range of health services. The funding is based on the numbers and characteristics (e.g., age, sex, and ethnicity) of people enrolled with them. That funding pays for:
· Providing care and treatment when people are ill
· Helping people stay healthy
· Reaching out to those groups in their community who have poor health or who are missing out on primary health care.
All PHOs receive additional funding for Health Promotion, and are able to access Services to Improve Access funding to provide new services or improved access to reduce health inequalities among high-need groups that are known to have the worst health status. Very Low Cost Access payment for PHOs and practices that charge very low fees to patients was introduced on 1 October 2006. The very low cost access payment was introduced as a way to support, encourage, and reward PHOs and their practices that, in order to deliver on very low cost access to primary health care and reduce health inequalities, have forgone revenue from patient fees.
Under the previous system, people often had their health information spread around several Medical Centres, with no one specifically keeping an eye on their health needs. In some situations, doctors have referred people to hospital or a specialist with important health information missing because not all the information was available to them. When a Medical Centre team is coordinating and managing your heath care, your health needs are best met.
District Health Boards (DHBs) are responsible for the ongoing management of any PHO in its area, which includes monitoring fees charged to patients to ensure government subsidies are being used appropriately. If you are concerned about the level of fees you are being charged, or have any general enquiries about enrolment or your PHO you should contact the Primary Care Portfolio Manager at Auckland District Health Board. Telephone 367 0000
Yes, you can still visit another doctor, for example, After Hours Accident and Medical Services, when you need another opinion, or if you're away from home and get sick – however, you will be a “casual” patient at these services.
One of the things PHOs are focusing on is improving care for people with chronic conditions, such as diabetes, heart or breathing problems.
A service called Care Plus has been introduced through PHOs and it is aimed at people who need to visit their family GP or nurse often because of these illnesses, have acute medical or mental health needs, or a life limiting illness. Care Plus services are provided at a low or reduced cost.
No, it is best to enrol with the Medical Centre you use most often.You can change doctors if you wish and you can visit other doctors or health care providers as a casual patient, and be charged casual rates. By building a relationship with your PHO health professional like your family doctor or nurse, they'll get to know you better and you'll get continuity of care.
Most doctors in Auckland are members of a PHO – you can ask at your doctor’s to confirm your enrolment.
Almost all Medical Centres are now part of a PHO. If you are not enrolled with a doctor and a PHO, ask your regular doctor if they are part of a PHO.
To enrol, you will need to sign a form which the medical centre receptionist will give you. The form will usually ask you for your personal details such as name, age, date of birth, address and ethnicity. The information collected at enrolment comes under the Privacy Act 1993 and the Health Information Privacy Code 1994, so the privacy of your information is protected.
Children under six years old are eligible for reduced cost doctor visits and free prescription medicines regardless of their doctor belonging to a PHO or not.
People who are aged 6 - 65+ and enrolled with a PHO are eligible to get:
· Reduced cost doctors fees
· Pay only $3 per prescription medicine (as long as the medicine is fully subsidised and as long as the prescription is from your usual PHO doctor).