Southern Primary Health Organisation chairman Dr Conway Powell rejects concerns about contract letting and says he is sick of "sniping" about the new organisation.
He said he could understand why some within the community health sector might be finding change difficult, but it was time to look at "positive things" being done for patients.
Dr Conway was responding to concerns raised by some general practices about the decision of the Primary Health Organisation (PHO) to contract Best Practice Advocacy Centre Inc (BPAC Inc) to develop a community electronic referral system for its clinical programmes without using an open tendering process.
Their concerns were that the organisation was not following the rules set down for this in the agreement with the Southern District Health Board and about possible conflict of interest related to Prof Murray Tilyard's connection with BPAC Inc.
Prof Tilyard is the executive director of BPAC Inc, a joint venture between the University of Otago and South Link Health (where he is also executive director) and he represents general practice on the organisation's board.
The organisation has contracted BPAC Inc to develop an IT referral system for its clinical programmes.
Dr Powell said the decision to offer the contract to BPAC Inc was made because the organisation was keen to get its clinical programmes working as soon as possible.
It was considered that BPAC Inc was the most competent, capable organisation in the country to develop the systems required, he said.
After a year, an open tender process would be used.
The programme being developed was "truly exciting" and would allow doctors to electronically refer patients to other health providers in the community along with the relevant funding, something which was not done previously.
Conflict of interest issues were strictly managed at the PHO board, Dr Powell said.
Prof Tilyard was not present when the contract was awarded, nor did he receive the relevant papers.
One of those concerned about the process, Dr Phil White, of the Amity Health Centre, said it was not appropriate for Prof Tilyard to be involved, but he was also concerned at the level of clinical input into the decision.
With Prof Tilyard correctly not involved, that left one other GP, which "dilutes the voice of GPs".
Doctors were the ones who would use the system every day and should have had a greater say in the decision.
There were other electronic referral providers who could have been interested in the contract, he said.
The contracts for financial and management services have also been awarded to South Link Health and accountants Polson Higgs for this year.
Both had been serving many of the previous nine PHOs and it seemed reasonable in the interim to continue that arrangement, Dr Powell said.
He asked whether all previous PHOs had put all contracts out for competitive tender or whether they had chosen those able to provide the best service.
Southern District Health Board chief executive Brian Rousseau said the organisation had been questioned about the issues raised over the IT contract.
The organisation had advised due process was followed and that two members with conflicts of interest were excluded from the decision, and that the service would be tendered in a year.
He said it was not unreasonable that in some cases open procurement was not followed.
This could include where the cost/benefit did not justify the approach, or where it could be established there were not multiple providers, or where relationship-based contracts were required.
It had been pointed out the board expected the organisation would conduct its affairs "in line with our expectations" and if the board became aware of an issue, that would be discussed.
The agreement with the organisation states that all sub-contracting arrangements demonstrate a transparent process for provider selection. It also refers to effective management of conflicts of interest.
In the principles for the formation of the new PHO, the board also asked that the PHO develop and/or contract administrative services, including IT services, "on merit, at best cost and at best economies of scale".
Asked whether making PHO meetings public was considered, Dr Powell said at some stage this "may well be appropriate", but in the establishment phase it was appropriate "for us to have good robust board meetings" followed by frequent communication with the media and "stakeholder groups".
Doctors also had input through representatives on the PHO's advisory groups and the organisation was working hard "welcoming comment", discussing concerns and trying to "get people on board".
(Primary health organisations are not subject to the Official Information Act or required to have their meetings in public.)
