How is Greece conforming to Alma-Ata's principles in the middle of its biggest financial crisis?

Abstract

The international Alma-Ata conference held on September 1978 by the World Health Organisation (WHO) set equity, comprehensiveness, continuity of care, and patient centeredness, as targets for all health systems in the world.1 In order to achieve these targets, it mobilised a ‘primary healthcare movement’ that shifted global thinking about health from specialist, tertiary care towards ambulatory care.2 WHO's report of 2008, Primary Health Care: Now More Than Ever ,3 reconfirmed WHO's adherence to primary health care as the only way for health systems to respond to the challenges of a changing world. How has Greece dealt with Alma-Ata's principals for the last 30 years? And how relevant are these principles today, in the middle of the country's biggest financial crisis? Inspired by Alma-Ata's ideals, Greece instituted a national health system in 1983, so that it could ‘ guarantee that all citizens enjoy the benefits of a complete range of services of high quality, free at the point of service ’.4 Since then, the Greek NHS has been providing free access and full coverage to the entire population, including immigrants. Within NHS or social insurance context, primary healthcare services are delivered through health centres and provincial surgeries in rural areas and through outpatient departments of regional and district hospitals, polyclinics of the social insurance institutions and contracted physicians and diagnostic centres in urban areas. There are also many private physicians and diagnostic centres that provide services directly to the population. A major shortcoming of the Greek healthcare system is that …