Significant job losses at WellSouth are on the cards as part of a shake-up of the primary healthcare system described as “shambolic” . The primary health organisation has been facing a rival group, thePHO, which has led to several of its GPs defecting. WellSouth chief executive Andrew Swanson-Dobbs would not say how many were affected in the restructure, but the ODT has been informed there could be significant job cuts. “There is currently no settled national policy on the future of primary care in New Zealand. “In the absence of one, significant structural change is being driven by individual funding and contracting decisions rather than by any coherent plan for how primary care should serve communities.’’ Mr Swanson-Dobbs said Health New Zealand’s approval of new PHOs to operate nationally prompted a number of practices — particularly corporate-owned practices — to switch PHOs from July. He said “24%” of the enroled population have “moved to other PHOs”. Primary Health Organisations (PHOs) are local groups of doctors, nurses, and health workers that manage government funds, provide lower-cost doctor visits, and improve community health. They receive government money based on the age, health needs, and number of patients signed up at local clinics. In December 2024, the ODT reported there were 78 practices in the WellSouth network. “Because funding follows enrolled patients, that decision flowed directly through to the resources available to place-based organisations such as WellSouth. “Added to that, PHO funding for this financial year was not confirmed until late June, days before it took effect, which left our board unable to finalise its budget until mid-July.” No organisation can plan a sustainable workforce in those conditions, Mr Swanson-Dobbs said. “Our proposal is about aligning WellSouth to the population we now serve and the funding we hold, but the deeper issue is a national one. Until there is a clear policy direction for primary care — how it is funded, how it is organised, and what communities can expect from it — this kind of disruption will keep landing on local services and the people who deliver them.” Mr Swanson-Dobbs said WellSouth's commitment to primary care across Otago and Southland was unchanged. “We continue to hold responsibilities across the whole Southern district, our focus is on protecting frontline and patient-facing services, and the majority of our clinical and in-practice roles are not in scope of this proposal.” University of Otago public health Prof Peter Crampton said he could not be specific about WellSouth’s woes, but said they were reflective of the primary healthcare sector in general. “At the moment, there's a lack of clarity about the direction of travel from the point of view of a national strategy for primary healthcare. And it’s shambolic,” Prof Crampton said. He said there was a growing trend of PHOs being taken over by private equity firms, who have a largely profit-minded approach to health. "That's a very significant development in the New Zealand healthcare system. “Their operandi is generally to buy, often on the basis of debt, to reduce costs. And that's done through a variety of mechanisms, including being selective about which patients are served. "There's quite a lot of evidence on this, mainly from the United States.” Staff consultation for WellSouth closes on July 31. “We expect to be in a position to say more from mid-August, once feedback has been genuinely considered,” Mr Swanson-Dobbs said.
