The Western Bay of Plenty Primary Health Organisation has been informed that Green Cross Health and Third Age Health plan to transfer to the Eastern Bay Primary Health Alliance.
The Western Bay of Plenty Primary Health Organisation has been informed that Green Cross Health and Third Age Health plan to transfer to the Eastern Bay Primary Health Alliance.
Several Bay of Plenty medical practices are joining the Eastern Bay Primary Health Alliance, affecting 46,000 patients.
Concerns have been raised about continuity of care and potential loss of services due to funding differences.
Green Cross Health and Third Age Health argue the move will better support the sustainability of general practices.
A funding-driven migration of medical practices with 46,000 enrolled patients from one Bay of Plenty primary health organisation to another has sparked concerns.
The Western Bay of Plenty Primary Health Organisation (PHO) has been informed that Green Cross Health and Third Age Health practices plan to transfer to the EasternBay Primary Health Alliance (EBPHA), based in Whakatāne.
Health New Zealand Te Whatu Ora contracts primary health organisations to provide primary health services within a geographical area.
Green Cross Health operates The Doctors practices – five in Tauranga and three in Whakatāne.
Third Age Health provides primary care services for residential care facilities.
‘Patients will suffer’
A PHO statement said general practices received most government funding through capitation – a fixed amount per patient paid annually, based on age, sex and being a Community Services Card holder.
Primary health organisations also received “flexi-funding”, which each organisation used differently to meet local health needs.
For example, the Western Bay PHO used it for nutrition services, outreach nursing services to support cervical and breast screening, and Ngāi Te Rangi‘s mobile health services.
“We choose to invest flexi-funding in services we know make a difference, because we understand what our community needs,” PHO co-chairman and GP Dr Dan McIntosh said.
McIntosh said decisions around funding and service delivery could differ when a practice changed PHO.
“Our concern is whether patient access to these services will be maintained.”
Western Bay of Plenty Primary Health Organisation chief executive Lindsey Webber.
Western Bay of Plenty PHO chief executive Lindsey Webber feared the services could stop.
“All indications show that they [the EBPHA] actually don’t want the PHO to be [the] deliverer of those services – they want all of the funding to go to general practice.
“Our concern is that patients will suffer because of the change in the business model the EBPHA seems to be backing.”
She said Health NZ would make the final decision on the change.
‘Difficult decisions’ required
Green Cross Health medical general manager Wayne Woolrich said its decision was part of a “broader strategy” to align with a funding and service delivery model it believed “better supports” the sustainability of general practice.
A “key” reason was the EBPHA operated as “a pure funder and planner of services”, allowing more primary care funding to “flow directly” into general practice.
The PHO followed “a more traditional model” of funding and providing the services itself.
“This structure reduces the proportion of flexi-funding reaching general practices.”
Woolrich said some Bay medical practices were operating at a financial loss and “difficult decisions” were required to ensure services continued.
Moving to the EBPHA allowed it to retain more funding for frontline services and reduce the need for fee increases – a “significant challenge” in the past few years.
“We acknowledge the concerns raised by Western Bay PHO leaders and wish to reassure patients and whānau that continuity of care remains our highest priority.”
It was working with the EBPHA to ensure a smooth transition, “with minimal disruption and ongoing access to essential services”.
A ‘more flexible approach’
Third Age Health chief executive Tony Wai said the change meant patients would have “greater access to high-quality primary care”, especially for palliative services.
“Our focus is on ensuring our ageing population has access to comprehensive care.”
Wai said funding arrangements with the PHO were “not fully aligned to our service model”.
He said discretionary funding was either not made available to Third Age Health for its residents due to network restrictions or was linked to services that did not meet the needs of its older, more acute patient group.
“In other regions, PHOs have taken a more flexible approach, providing direct funding that allows us to tailor care more effectively to our population.”
Moving to the EBPHA “better reflects our commitment for national consistency”, he said.
Continuity of care ‘utmost priority’
EBPHA interim chief executive Katarina Gordon said it welcomed the two companies making the “big move”.
“Ensuring the continuity of care for all patients is our utmost priority throughout this transition.”
Gordon said it was still working on the specifics of how it would use flexi-funding but aimed to address health inequities and enable services tailored to meet diverse community needs.
This would “empower practices to be responsive to the unique requirements of their patient populations”.
Asked what PHO-funded programmes would continue to be funded by the EBPHA and which would stop, Gordon said it was working with the transferring practices, Health NZ and the PHO to review the programmes.
“Our priority is to ensure the continuation of essential services that directly benefit whānau wellbeing and align with our partnership principles of remaining whānau-focused and equity-driven.”
A risk assessment process was also under way.
Health NZ Te Manawa Taki planning and funding outcomes regional director Nicola Ehau said the agency was aware of the movements and working with the PHO and the EBPHA.
It had not yet received formal notification of new subcontracted providers.
“Once we do, our regional team will work within the 20-business-day timeframe to advise our position.”
Megan Wilson is a health and general news reporter for the Bay of Plenty Times and Rotorua Daily Post. She has been a journalist since 2021.
