Thursday, 5 November 2009

The Health of the Primary Health Sector

Primary health care

From the Ministry of Health's primary health care website, primary health care means 'health and preventative services, including health education, counseling, disease prevention and screening'. Primary health care is coordinated by 81 PHOs across the country - to raise the level of health and well-being of all New Zealanders.

Can this ideal - that we should all have the same access to health care services and encouragement to lead healthier lifestyles - survive the latest political moves to reduce administrative costs at the PHO and DHB level? Or will some of us (rural people and ethnic minorities) be left out in the cold again?

John Hicks' recent article in the Southland Times on the demise of Southland's PHOs and its effect on rural people is worth a read. You can even comment on his article directly on the Southland Times website - just click on the comment link. Will a big, broad Southland (or Otago?) PHO be sensitive to the fact that towns like Otautau need help in retaining good doctors and nurses? If change is in the air, then have your say on how you would like to see primary health care administered in our local community.


Anonymous said...

The vision of the Primary Health Care Strategy is that the community would be involved and that they would seek solutions and create partnerships with all providers - most importantly Doctors and local health professionals.

John is quite right, the Doctors union (South Link Health) wants to take that all back to a medical model with no place for the community.

PHO's work fantastically well where the GPs, Pharmacists, Nurses, Maori and NGOs come together and work on community based solutions.

SLH is a provider of services to GPs. I understand some (such as IT) are now great and cost effective. A benefit of PHO supervision which in fact the GPs don't acknowledge. They top slice contracts and provide benefits to GPs like a conference or three every year as well as salaries for Murray Tilyard.

With the advent of PHOs the SLH top slice declined and other folks got the benefit (not I hasten to add the community). So GPs carried on much as before with a few less conferences - small community trusts did better and were able to provide cheaper care - look at the web-sites. GP owned practices still charge more than the Trust owned practices.

Any ways the community seems apathetic and they are about to see the standard of primary health care decline and the GPs and SLH get richer.

Cathy said...

Yes, I can understand the view that the community appears apathetic, but I also feel as a community member that there hasnt been a tremendous outreach by our local PHO to get community feedback. Anyway, it seems that whatever goes on behind DHB doors is unaffected by community opinion so in that climate, it's no wonder that the community appears apathetic.

I know that our local PHO has done some good things such as helping people in Ohai and Nightcaps get insulation for their homes. I felt this was positive and proactive and would've liked to have seen more of it done throughout our area.

But now I wonder if all four Southland PHOs are devolving into one, how will rural and ethnic representation be affected? Could a project like getting the cold, drafty houses in Ohai insulated ever get support from a PHO run by a board that is not in touch with the various small communities of Southland?

Thanks for your comment - it gives a lot of food for thought.

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