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1. What is a Primary Health Organization?
The long term vision of the New Zealand Primary Health Care Strategy is for everyone to have access to healthcare services that "improve their health, keep them well, are easy to get to and co-ordinate their ongoing care". Primary Health Organizations (PHOs) have been developed to make this happen.
2. How are PHOs different?
PHOs are different from the previous system in that they are funded for each person enrolled with them, rather than getting money ever time someone visits a GP. This means that GP practices will have incentives to keep their enrolled population well instead of just treating people when they get sick. PHOs get special funds for health education activities so we can expect to see more Health Promotion programmes in our communities in the near future. Another difference that may be noticed over a period of time is a decrease in the cost of accessing health services. Already PHOs have been allocated extra funding for youth (effective from 1 October 2003), for people who have chronic illnesses and high needs, and for low-income families.
3. What is the difference between an Access PHO and an Interim PHO?
While both Access and Interim PHOs receive funding for their enrolled population, Access PHOs get more so they can lower the fee charged directly to patients. To become an Access PHO, at least 50% of the PHOs population must be Maori, Pacific Island or from the most deprived 20% of New Zealand. HealthWEST is an Interim PHO; Waiora Amataga is an Access PHO.
4. What happens if I want to go to a doctor in another PHO for some aspect of my healthcare?
That's fine - you have the right to choose. You can only be enrolled with one PHO but there may be times when you need a second opinion, require emergency after hours care, or you might sometimes visit a doctor near where you work rather than where you live. Because the PHO you are enrolled with gets funded for looking after you, your usual PHO will pay the other GP you visited for your visit. The reason for your visit will not be disclosed. The aim of a PHO is to maintain as well as restore your health and that is best done though consistently visiting your usual practice, but it's not compulsory.
5. Who will notice an immediate difference under the PHO system?
Improving the health of the New Zealand population means focusing on people with poorer health - those that are less well off, as well as Maori and Pacific Island populations. These groups will find they receive more thorough and regular care under a PHO as well as lower charges.
6. How do I enroll with a PHO?
If you have been to see a GP recently you will be automatically registered with the PHO that your GP practice belongs to. Next time you visit your GP you may be asked to sign a form or give your consent to be enrolled at that PHO. AT that time you should also be given information about what that means.
You can also enroll any of your children provided they are less than 16 years of age.
Enrolment is voluntary and if you choose not to enroll you will still be able to visit any health professional to get the care you need.
7. How will the privacy of patients be protected within the PHO when many people will have access to patient information?
Patient information will still be protected by the Privacy Act 1993 and its corresponding Health Information Privacy Code 1994. Registration information (but not your medical information) will be shared with the Ministry of Health, however this will only be for payment purposes and will not be disclosed to any other party. Clinical information will only be shared with those directly involved in your care.
8. What resources will be available to support community participation?
It is a core requirement of a PHO to involve their community in its governance processes and to be responsive to its community's needs. Therefore resources will be available to fund community representation on governance structures (such as on Board of Directors) as well as to consult the community on the same health issues.
9. What type of things will the community be able to have input into through the community representatives?
Community participation will be encouraged at many levels of the PHO. At the governance level the community representatives on the board will have input and voting rights in all aspects put before the board. In addition, community people may be asked to present to the board where necessary on relevant community issues. At the broader level the community may be asked, through a consultation process, to give their views on the priority areas for a PHO to provide services.
10. What systems will PHOs have in place for handling complaints about practitioners or services?
This will be the same as it is now. In the first instance, the complaint should be taken up with the practice in question according to their complaints procedure. If you are still not satisfied then you can go to the Health and Disability Commissioner who may or may not refer on to the relevant professional body.
11. How will PHOs work together to benefit their communities?
PHOs have to work with each other and their communities on key initiatives and priority areas. PHOs will also share information about things like the number of Diabetes or Flu cases they are seeing. This will help them plan for local healthcare requirements more effectively.
12. How to get more information about PHOs.
Ask your GP practice.
Visit the Ministry of Health's Website at www.moh.govt.nz/primaryhealthcare.
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