Comparison of independent practitioner associations and similar groups (pre-2001) with primary health organisations

Independent practitioner associations and others5 6 13 Primary health organisations
Size 59 groups with 2000 to 500 000 patients 81 organisations with 4000 to 340 000 patients
Ownership Mostly private companies with growing proportion shifting to non-profit status; others all community owned, non-profit Community owned, non-profit
Governance Governing board (GP dominated) elected by members (GPs and practice nurses). Wide range of mechanisms for consulting community. Member practices remain separate businesses but receive services and some funding from associations Governing board elected by members (GPs, practice nurses and others, including lay representatives). Practices remain separate businesses
Funding Mostly fee for service subsidies and patient copayments; some capitation; some had budgets for laboratory tests and drugs Capitation at the primary health organisation level passed to practitioners and patient copayments (two separate funding streams)
Patient registration GPs held patient records, but no formal enrolment with GPs Patients must enrol with primary health organisation through their GP
Patient subsidies For children under 6 year olds, those on low incomes, and those with high health care needs For all New Zealand residents by mid-2007
Patient charges GPs set fees. Free for most under-6 years. Up to $NZ25 for subsidised patients and $NZ55 for others Fees likely to be $NZ0-$NZ30 once universal subsidy is in place. GPs still free to set fees after negotiation with district health boards and between primary health organisations
Services provided Wide range of primary care, with some secondary care integration. Additional free services funded through savings from budgets for laboratory tests and drugs Wide range of primary care, with some secondary care integration. Additional services to improve access and care for patients with chronic needs. No budgets for laboratory tests or drugs

GP=general practitioner.