Developments in Australian general practice 2000-2002: what did these contribute to a well functioning and comprehensive Primary Health Care System?

Gawaine Powell Davies,John Furler,Julie Mcdonald,Mark Harris,Wendy Hu,Elizabeth Harris

doi:10.1186/1743-8462-3-1

Gawaine Powell Davies, John Furler + Show 4 more

Open Access

https://doi.org/10.1186/1743-8462-3-1

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Abstract

BackgroundIn recent years, national and state/territory governments have undertaken an increasing number of initiatives to strengthen general practice and improve its links with the rest of the primary health care sector. This paper reviews how far these initiatives were contributing to a well functioning and comprehensive primary health care system during the period 2000–2002, using a normative model of primary health care and data from a descriptive study to evaluate progress.ResultsThere was a significant number of programs, at both state/territory and national level. Most focused on individual care, particularly for chronic disease, rather than population health approaches. There was little evidence of integration across programs: each tended to be based in and focus on a single jurisdiction, and build capacity chiefly within the services funded through that jurisdiction. As a result, the overall effect was patchy, with similar difficulties being noted across all jurisdictions and little gain in overall system capacity for effective primary health care.ConclusionEfforts to develop more effective primary health care need a more balanced approach to reform, with a better balance across the different elements of primary health care and greater integration across programs and jurisdictions. One way ahead is to form a single funding agency, as in the UK and New Zealand, and so remove the need to work across jurisdictions and manage their competing interests. A second, perhaps less politically challenging starting point, is to create an agreed framework for primary health care within which a collective vision for primary health care can be developed, based on population health needs, and the responsibilities of different sectors services can be negotiated. Either of these approaches would be assisted by a more systematic and comprehensive program of research and evaluation for primary health care.

Highlights

In recent years, national and state/territory governments have undertaken an increasing number of initiatives to strengthen general practice and improve its links with the rest of the primary health care sector
Much recent activity has sought to strengthen the role of general practice in the Australian primary health care sector and its links with other services [5]
Insufficient capacity This was seen to limit what could be achieved through general practice and other primary health care services, either separately or working together

Summary

Introduction

National and state/territory governments have undertaken an increasing number of initiatives to strengthen general practice and improve its links with the rest of the primary health care sector. In Australia, as in other developed countries, demands for healthcare services are increasing This is fuelled by longer life expectancies, technological advances and high consumer expectations, and constrained by limited budgets and increasing health care costs. There is still some disagreement about the role of general practice within Primary Health Care, linked in part to ongoing debates about the scope of primary health care [6] This has contributed to a dissonance between the broad thrust of program and policy initiatives and the underlying conceptual debates, and created an uncertain environment for the development of a comprehensive PHC sector and of a supporting research and development agenda

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