Better Sooner More Convenient Primary Care - New Zealand Doctor

Option D: PHO/DHB jointly owned Primary & Community services entity
DHB Board / CEO
PHO Board
DHB
funder
P & C Trust or
alliance contract
DHB
secondary
services
Shared
corporate
services
GM primary &
community
Region-wide services
IFHCs
Under this option the DHB and PHO Boards form an alliance either using contractual
arrangements or a joint venture entity, to achieve integrated management of primary and
community services. Over time, the continued need for the parent bodies could be assessed.
7.2 Assessing the options
In any of options B, C and D, a West Coast based entity assumes responsibility for the operation
of the community based, non hospital services, currently operated by the DHB, including primary
care services, and the current functions of the PHO.
The option of the PHO disappearing, and the DHB assuming responsibility for the entirety of
primary and community services (Option B) is not attractive to either the existing PHO or to
private providers. This option is also unlikely to assist the sector in managing within available
funding. It could also lead to less local influence and orientation, should the West Coast DHB's
understandable moves to work more closely with Canterbury DHB, lead eventually to its own
disappearance as an independent entity.
Therefore, most thinking has been focused on developing Options C and D. Both of these come
with some possibilities for interim steps and a staged approach. For example, it may be that the
DHB might continue to employ and remunerate staff, and the focus of effort in the first year
be on integrating actual service delivery (rather than on changing organisational structures).
The PHO and DHB boards have established a joint management and clinical working party to
consider the costs and benefits of the organisational options and to come up with firm
recommendations to their respective boards by 30 April 2010.
Business case EoI V38 AC 25Feb10 Page 55