Why tying GP pay to targets can backfire
New Zealand tied $40 million in GP payments to health targets including 90% infant immunisation and 80% cervical screening.
The scheme rewards clinics that meet specific health targets or make progress toward them. Experts warn that the same targets may not work equally for all practices.
A clinic in an affluent area might easily hit the smoking-cessation target because fewer patients smoke. A clinic in a poorer area faces much steeper odds with the same targets.
International evidence suggests performance-based funding can improve some aspects of care while neglecting others. Practices may focus so heavily on measurable targets that they sideline harder-to-measure skills.
These skills include trust, continuity of care, and managing complex health conditions. The United Kingdom's Quality and Outcomes Framework started in 2004.
It first improved care for some conditions. But once targets were hit, improvement slowed.
Care for non-targeted conditions declined.
- NZ$40 million
- Total funding
- 90%
- Infant immunisation target
- 80%
- Cervical screening target
- 64% vs 88%
- Northland vs Canterbury rates
Why it mattersWhen funding rewards hitting targets, clinics may focus on what's easy to count. They may miss what actually helps patients get healthier.
AustraliaNo direct Australian effect yet, but Australia's own GP funding models face similar pressures to link payments to measured performance.
✓ Claims checked against the source. checked 2 h ago
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