THE DEVELOPMENT OF INDEPENDENT PRACTICE ASSOCIATIONS AND RELATED GROUPS IN NEW-ZEALAND

Aims. independent practice associations (IPAs) have become an importan t feature of New Zealand's primary care system in the past two years a nd now represent nearly 60% of general practitioners. This survey was undertaken to document this important development. To determine the ex tent of the development of IPAs, their goals and barriers to achieving these goals, their policies, financing and contracting development. M ethods. Questionnaire sent to 42 IPAs and related groups in October 19 94 with a supplementary questionnaire in April 1995. Results, There we re 34 responses, representing the views of 1263 general practitioners. Most important goals were ''achieving better health outcomes for pati ents'', ''making better use of primary care resources'' and ''improvin g the health of the community you serve'', Significant barriers to ach ieving these goals were ''lack of time'' and 'lack of clear RHA polici es''. There was little support for financial risk sharing or for membe rs personally retaining savings from budget holding, Although there ha d been significant progress with budget holding considerable frustrati on was expressed about contracting relationships with RHAs. Conclusion . The survey shows that general practitioners are seeing IPAs as ways of achieving professional goals, better quality health care and improv ing health status outcomes rather than as a means of personal gain. Ho wever, protecting and advancing the status of general practice was als o important. IPAs expect to move progressively into both budget holdin g and managed care with the gradual assumption of secondary care servi ces purchasing. This has important implications for the future of RHAs including the need for them to adopt a more strategic purchasing role .