The State of Third Sector Primary Care in New Zealand

Abstract

This thesis details the state of third sector primary health care in New Zealand. It examines what third sector primary health care organisations look like within the contemporary New Zealand setting. This thesis also identifies recent policy changes that have occurred within the primary health sector, and discusses the implications these changes in health policy will have for third sector primary health care providers. It identifies current policy threats and opportunities facing third sector primary care providers. This study also examines how these policy changes can be explained through the relevant policy literature. This thesis found that third sector primary health care in New Zealand plays an important role in the provision of primary health care services to vulnerable communities. This finding is consistent with literature from New Zealand and overseas demonstrating the importance of third sector provision of primary care services to low-income, indigenous and vulnerable groups. This study also found that current changes in health policy are having a significant negative impact on third sector primary care organisations. Policy changes in the health policy environment that are seeing mergers between PHOs are causing third sector organisations to lose their ability to pursue an independent PHO strategy, and are eroding third sector primary health care services. The erosion of these services is of concern to senior health sector leaders. The findings of this thesis are significant as the loss of third sector primary care providers could have serious implications for the health system. The findings from this thesis also raise important policy questions about how primary care policy will need to respond to meet the needs of vulnerable communities if the ability of these organisations to provide services is reduced. If third sector organisations cannot retain their identity post-merger or larger PHOs are unable to pick up third sector priorities, the impacts from these policy reforms on population health will need to be monitored.