The future of PHOs: why getting it right matters for general practice

Primary health organisations (PHOs) have been part of New Zealand's health system for 25 years. During that time, they have developed different approaches to supporting general practice and responding to the needs of their communities.

Now, with their future under consideration, we have an opportunity to look at what PHOs contribute, what could be improved and what the health system needs from them in the years ahead.

For Pinnacle, the starting point is general practice.

The work behind general practice

General practices are managing growing demand, workforce pressures and increasingly complex patient needs. They need practical support to remain sustainable and continue providing care in their communities.

At Pinnacle, that support extends well beyond funding administration.

Across Waikato, Tairāwhiti, Taranaki and Lakes, we work with general practices on clinical and operational matters, workforce development, digital systems, new models of care and improving access to services.

We also work across organisational boundaries, bringing providers together and coordinating initiatives that individual practices would struggle to deliver alone.

One example is Te Ara Tupu a Manawa Taki Workforce Hub, co-led by Pinnacle and Hauraki PHO. Working across 11 PHOs, the Hub connects primary and community healthcare workers with training, funding and professional development opportunities.

This kind of regional coordination is an important part of what PHOs contribute to the wider health system.

Why the future of PHOs matters

Decisions about the future of PHOs will have consequences well beyond the organisations themselves.

The work PHOs currently undertake won't disappear if their structures change. General practices will still need support, regional workforce development will still be necessary, and someone will need to coordinate services and respond to local population health needs.

Any proposal to significantly change or replace the current model must therefore answer some practical questions. Who will take responsibility for these functions? How will existing relationships and expertise be retained? What will the changes cost, and what evidence is there that alternative arrangements would deliver better results?

These are reasonable questions to ask before making decisions that could affect general practices and the people who depend on them.

We also recognise there is room for improvement. PHOs have developed differently across the country, and clearer responsibilities, consistent expectations and stronger accountability would benefit the sector.

A clear role for the future

These priorities are reflected in the 2026 election manifestos published by Network4, of which Pinnacle is a member, and General Practice New Zealand (GPNZ). Both call for greater certainty, sustainable funding, workforce support, better-connected services and more care delivered closer to home.

That agreement across the sector reinforces the need for a clear direction for primary care, including the role PHOs will play.

Pinnacle supports retaining and strengthening the PHO model, with a clearer national direction, appropriate resources and sufficient flexibility to respond to regional needs.

Reform should build on the work already being done, address what isn't working and demonstrate how any changes will improve support for general practice and patient care.

After years of uncertainty, the sector needs decisions that provide confidence for the future. General practices need stability, and the communities they serve need accessible, well-connected primary healthcare.

That's what any decisions about the future of PHOs should ultimately deliver.