Primary health care in Europe—problems and solutions

Abstract

In Europe th development and promotion of primary health care is no simple task. It is made more difficult by 3 common fallacies: primary health care is something new invented at the Alma-Ata Conference on Primary Health Care and since propagated by the World Health Organization (WHO); primary health care is something for the developing countries and irrelevant for the needs of the industrialized countries; and primary health care is identical with primary medical care. The 3 fallacies are just that. Primary health care has a long tradition even in the industrialized countries. It is relevant for them and primary medical care is not a substitute for primary health care. Yet the development of primary health care in Europe is fraught with problems -- conceptual problems political and attitudinal problems organizational problems managerial problems and training problems. The concept of primary health care as advocated by WHO is somewhat nebulous. There are 4 ways the concept of primary health care can be and has been interpreted: primary health care as a set of activities as a level of care as a strategy of organizing health care and as a philosophy. In 1979 the Regional Committee for Europe of WHO discussed primary health care. On the basis of their official statements the European Member States could be put in 4 groups: countries that claimed they already have implemented primary health care; countries in the process of reforming their medical education who felt that after having introduced training elements related to general practice and family medicine they would have primary health care; countries that were worried about the situation and determined to reorient their health care system; and countries that wondered what primary health care was all about. The primary objective of the activities of WHO is to initiate and encourage in the Member States development which expands health systems toward primary health care. Trends and developments in the Members States are identified.