Premium
Commissioning and equity in primary care in Australia: Views from Primary Health Networks
Author(s) -
Henderson Julie,
Javanparast Sara,
MacKean Tamara,
Freeman Toby,
Baum Fran,
Ziersch Anna
Publication year - 2018
Publication title -
health and social care in the community
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.984
H-Index - 68
eISSN - 1365-2524
pISSN - 0966-0410
DOI - 10.1111/hsc.12464
Subject(s) - project commissioning , equity (law) , population health , health care , population , nursing , public relations , business , medicine , public health , publishing , economic growth , political science , environmental health , law , economics
This paper reports findings from 55 stakeholder interviews undertaken in six Primary Health Networks ( PHN s) in Australia as part of a study of the impact of population health planning in regional primary health organisations on service access and equity. Primary healthcare planning is currently undertaken by PHN s which were established in 2015 as commissioning organisations. This was a departure from the role of Medicare Locals, the previous regional primary health organisations which frequently provided services. This paper addresses perceptions of 23 senior staff, 11 board members and 21 members of clinical and community advisory councils or health priority groups from six case study PHN s on the impact of commissioning on equity. Participants view the collection of population health data as facilitating service access through redistributing services on the basis of need and through bringing objectivity to decision‐making about services. Conversely, participants question the impact of the political and geographical context and population profile on capacity to improve service access and equity through service commissioning. Service delivery was seen as fragmented, the model is at odds with the manner in which Aboriginal Community Controlled Health Organisations ( ACCHO s) operate and rural regions lack services to commission. As a consequence, reliance upon commissioning of services may not be appropriate for the Australian primary healthcare context.