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Primary care organizations in New Zealand and England: tipping the balance of the health system in favour of primary care?
Author(s) -
Smith Judith,
Mays Nicholas
Publication year - 2007
Publication title -
the international journal of health planning and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.672
H-Index - 41
eISSN - 1099-1751
pISSN - 0749-6753
DOI - 10.1002/hpm.866
Subject(s) - enthusiasm , primary care , purchasing , public relations , health care , public health , population health , service (business) , population , business , nursing , medicine , political science , economic growth , marketing , psychology , family medicine , economics , environmental health , social psychology
This paper examines the experience of developing primary care organizations (PCOs) in New Zealand and England, exploring how far these new institutional forms have been able to ‘tip the balance’ of their host health system in favour of primary care. The original objectives for establishing PCOs in the two countries are assessed using published research evidence on the impact of PCOs covering: efficiency and cost containment; the development of clinical engagement and leadership; the development of primary care; and the purchasing of secondary and referred services. It is concluded that in both countries, progress has been made in aligning more closely the individual focus of general practice with the population perspective of the wider public health system. The New Zealand approach of using non‐governmental PCOs is judged consistent with harnessing the professional culture of general practice towards community‐based public health. By contrast, English primary care trusts (PCTs) are at risk of becoming remote from their origins as purchasers in primary care and general practice, unless the re‐introduction of practice‐level purchasing can provide GPs with new enthusiasm for local planning and service development. Copyright © 2007 John Wiley & Sons, Ltd.