PHOs

All GP practices and medical centres have joined Primary Health Organisations (PHOs), the government’s latest model for providing primary health care to New Zealand communities. What are PHOs, and what does this mean for you ?

They are local groups of primary health care providers responsible for organising and delivering primary health care to meet the needs of those enrolled with them. The government has put a lot of additional money into primary health care through this process.  They get a set amount of funding from the government to subsidise a range of health services.

Westgate Medical Centre is a member of ProCare PHO. It is important to realise that in order to enrol in a PHO you need to be eligible for publicly funded heath care in New Zealand and will need to provide evidence of this such as a New Zealand Passport, New Zealand Birth Certificate or any Passport containing a valid Permanent Residency Visa which is valid for more than two consecutive years. Further information can be obtained here from the Ministry of Health.
They will give their communities, iwi, and enrolled people the opportunity to have a say about the services the PHO provides.

So what does this actually mean for me ? See Fees

• Cheaper consultation fees (approximately 50% of the consultation fee is funded by the government)
• Cheaper prescription fees of $5 per item with a maximum of 12 script charges per year then all further scripts are free.
• MMH

Plus:

• One free annual diabetic review for diabetic patients
• Two free 6 monthly sexual health/contraception visits for under 22’s * – for Maori/PI only
• Care Plus for free nursing care for certain chronic conditions.
• Primary options-a scheme to treat some people in primary care who would otherwise be sent to hospital. Casual patient transfer to A&M.
• Access to government for diabetics, diabetic eye screening and podiatry care, Care Plus, nurse clinics.

The funding is based on the numbers and characteristics (e.g. age, sex, ethnicity) of people enrolled with them, The funding will pay for services to:

• Provide care and treatment when people are ill
• Help people stay healthy
• Reach out to those groups in their community who have poor health or are missing out on primary health care.

The government plans to increase funding to PHOs with the aim of reducing the cost of primary health care for everyone over time.

Why should you enroll with a PHO?

1. You will receive the same services and more to ensure that you and your family stay well and healthy
2. You will help us to better understand your health concerns and improve the health of your family.
3. We can work with other health services in your area to make sure that you and your family receive all the benefits and have access to good quality health care.

Enrollment is easy at WMC

• If you are a regular patient
• If you have already enrolled with us, we would like to make sure that you are happy to be enrolled with us and that the information we have about you is correct, for example, your ethnicity, spelling of your name, age, date of birth and address.
• If you have questions about your enrolment, please ask at reception.
• If you have not checked your details yet, please ask at reception.
• If you are a new patient.
• If you do not always use our service but would like to enrol, please ask at reception. Once you are enrolled with us, it means you have chosen our service to provide your ongoing health care needs. You do not have to be enrolled with us to use our health service. Enrolment Form

Frequently Asked Questions about PHOs

Can I enrol with two Primary Health Organisations?
No. You should enrol with the service you use most often. You can still visit other primary health care professionals, but there are benefits when you get most of your health care from your usual doctor, nurse, or health service.

What will happen if I do not enrol with a Primary Health Organisation?
Enrolment is voluntary. If you choose not to enrol, you will still be able to visit any primary health care professional to get the care you need. Your health professional will still receive any subsidy the government currently gives them, although this may not be as much as that provided for enrolled patients.

Can I enrol my children?
Yes, you can enrol any children in your care if they are 16 years of age or under. Ask at reception to find out what you need to do. We can only consider applications for enrolment for children where at least one parent is enrolled with us.

Can I enrol other members of my family or whanau?
No, if they are over the age of 16 they need to enrol themselves, unless you have Power of Attorney or you are their authorized representative.

Will I still need to pay to see my GP or nurse?
You will still have to pay to see your GP or nurse, but once your enrolment is processed by the Ministry of Health and if you are eligible for subsidised consultations, we will be able to offer reduced fees, or even free care for some categories of patients.
All our standard charges and the reduced charges available to enrolled patients that receive the additional subsidies from the Ministry of Health, are displayed on the notice boards at reception. If you have any questions about the health services provided or cost, ask at reception.

What happens to my enrolment information?
When you enrol, the PHO will use the information collected from you to build an enrolment register. This register is sent to the Ministry of Health where your information will remain confidential.

The Ministry of Health needs this information to:

• Calculate the funding that is given to the Primary Health Organization
• Correct your details on the National Health Index
• Monitor quality of care

The following information is kept:

• Name and address
• Date of birth, gender and ethnicity
• CSC (Community Services Card) number and expiry date (and if applicable) High User Card and expiry date
• National Health Index (NHI) number known by the PHO
• Whether you are a New Zealand resident or not

The date of your enrolment and the date you last visited your doctor or nurse. The reason for your visit will not be sent to the Ministry of Health