Table 3.

Primary health care and community pharmacy in Aotearoa/New Zealand

Primary health care in NZ is predominantly delivered through general practices, which act as gatekeepers to specialist services. Most people enrol in a general practice, which then receives a weighted capitation payment per quarter from the Government, with higher amounts given for enrolled populations with greater deprivation and health need [34]. General practices primarily operate as small businesses and charge co-payments for services. In addition to medical prescribers, several other health professional groups, including nurse practitioners, dentists, some nurses and a small number of pharmacists, can prescribe, usually within a specific scope of practice. Most medicines are subsidized but a co-payment of $5 per dispensed item is charged for the first 20 items per individual or family per year (Medicines Act 1981). Prescriptions and standard consultations to general practices are free for children under 14 years of age.

Community pharmacies, which are either small businesses or franchised chains, are variously located: some are co-located inside or next to general practices; others are inside shopping malls or large supermarkets; others are stand-alone in community shopping areas. Some online services with home delivery of medication have also developed recently. NZ law requires a pharmacist to be on-site at all times to dispense or check the dispensing of other technician staff and to advise customers on medicines. Patients choose which pharmacy to use and are not required to use the same pharmacy for every prescription