Tend is preparing to operate on new terms since the company will become its own PHO from 1 July. The move will allow direct contracts with Health New Zealand and expanding its control over service delivery.
80,000 Patients Transitioning in July
Tend will sever ties with five regional PHOs under the new model, including the Western Bay of Plenty PHO. About 80,000 enrolled patients are expected to be under the new direct contract with Health NZ by 1 July, with an additional 100,000 projected to follow within the year.
A Tend spokesperson said the move represents a “significant milestone” toward more modern and patient-centred care.
“It enables us to streamline funding flows, reduce unnecessary administrative layers, and deliver more coordinated, efficient care across the communities we serve.”
Rethinking the PHO Model for Modern Care Delivery
Tend co-founder and co-chief executive Cecilia Robinson argues the current PHO model no longer reflects the needs of a modern health system.
“The current PHO model is outdated, fragmented, and increasingly disconnected from the needs of modern general practice,” she said.
Robinson called for a reversal of the current structure. “Primary care providers should have the choice to commission PHOs for support, not the other way around.”
She added, “That’s how we’ll drive more funding to the front line, support equity and innovation, and ultimately improve the health care experience for every New Zealander.”
Tend’s approach echoes recommendations from the 2020 Health and Disability System review, which supported direct contracting between general practices and the government.
Sector Response Highlights Diverging Views
Health NZ confirmed that it approved Tend’s application for Canterbury, metro Auckland, and Bay of Plenty. Living Well director Martin Hefford explained that PHO-related consultations had been put on hold. “Health NZ is now not proceeding with consultation regarding the functions of PHOs this year, as related policy work is being undertaken,” he said.
The decision has raised concerns in the sector. General Practice New Zealand chief executive Maura Thompson questioned the transparency of the process.
“Tend’s announcement was very recent,” she said. “We’re seeking clarity from Health NZ about the ‘unclear’ process leading to its decision.”
Thompson stressed the importance of PHOs in the system, saying they play a “critical” role in ensuring equity and cohesion in primary care.
Realignments Indicate Wider Sector Movement
Tend’s move marks the third provider to exit the Western Bay of Plenty PHO. Green Cross Health and Third Age Health are also shifting 46,000 patients to the Eastern Bay Primary Health Alliance in a similar realignment. Western Bay PHO chief executive Lindsey Webber said her organisation supports change that keeps patients at the centre, but rejected criticisms of PHO contributions.
“We strongly disagree with claims that undervalue the role of PHOs,” she said, citing a “long history” of supporting general practice and providing wraparound community services.
“We are here to ensure everyone can access the care they need, in ways that suits them. We believe patients should have options, because healthcare is not one-size-fits-all.”
Tend’s approval to become its own PHO signals change, but the future of New Zealand’s primary health organisations remains unsettled. It’s unclear how many providers might follow — or what shape the sector will take next, with policy still in development.