Northland primary health provider Mahitahi Hauora offers GP practices $2.5m to stay onboard

Mahitahi Hauora's proposed approach to community healthcare will have to be approved by the Northland DHB. Photo / Michael Cunningham

Northland's primary health entity that came under the spotlight recently is proposing to end top slicing and free up $2.5 million for use by general practices in ways they know work best.

After wide consultation with relevant stakeholders and the community at large late last year, Mahitahi Hauora is seeking to move away from the role of "middleman" to a service-oriented relationship with GP practices, Māori health providers, whanau, and the wider primary healthcare sector.

Four GP practices in Whangārei have left the entity and seven are leaving at the end of June due to frustration over funding arrangements and a working relationship that has deteriorated over the years.

The amount of top slicing by the PHE, or overhead costs Mahitahi Hauora deducts from the funding provided by the Northland District Health Board - suspected to be up to 15 percent - is among concerns raised by the irate GPs, as well as allegations about a lack of transparency and accountability by the board.

Under a fresh approach to community healthcare, Mahitahi Hauora chief executive Jensen Webber said the PHE proposed to re-sign contracts and focus on delivering those services primary healthcare providers specifically requested.

The proposed changes are subject to approval from Northland DHB.

Webber said all practices would be funded using the same funding formula, ensuring 100 per cent financial transparency.

"General practices would still be able to access their Mahitahi Hauora relationship partner for all their everyday needs, we would still operate as a PHE in supporting them to meet all their commitments."

Webber said the changes, in turn, would mean an end to Mahitahi Hauora's complex contract arrangements and their obligations.

General practices would receive all funding through a single contract with the PHE, he said, with accountabilities clearly laid out in a service agreement.

Webber said Te Tai Tokerau was a complex landscape of primary health providers operating in different spaces and with many varying and sometimes competing priorities.

"Under our proposed new approach, the core focus of Mahitahi Hauora would be to become relationship partners to the system. We would offer services to general practices, Māori health providers, community organisations and groups, NGOs, whānau, iwi, and other movers in community healthcare, and we would share our skills, expertise and knowledge of the Northland health system.

"By taking this new approach we can more effectively support community aspirations for achieving equity and addressing disparity in a way that is driven by whānau and communities themselves and what matters to them."

NDHB chief executive Dr Nick Chamberlain said NDHB has agreed to further discussions with Mahitahi Hauora on its intentions but has not agreed to any of these changes as required under its funding agreement.

"It is unlikely NDHB would agree to any pass-through of funding without clear service delivery improvements," he said.