critical-analysis-primary-health-care-strategy-sept09
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critical-analysis-primary-health-care-strategy-sept09
Critical analysis of Primal-)' Health Care Strategy implementationJudith Smith, Ministry of Health. March 2009Critical analysis of the implementation critical-analysis-primary-health-care-strategy-sept09 of the Primary Health Care strategy implementation and framing of issues for the next phaseA paper prepared for the Ministry of Health39873Judith SmithHead of Policy, The Nuffield Trust, LondonVisiting Academic Fellow, February 2008 - January 2009 Sector Capability and Innovation DirectorateMinistr critical-analysis-primary-health-care-strategy-sept09y of HealthJudith,smith(a>nuffieldtrust,org.uk1Critical analysis of Primary Health Care Strategy implementationJudith Smith, Ministry of Health, Marchcritical-analysis-primary-health-care-strategy-sept09
2009Critical analysis of the implementation of the Primary Health Care strategy implementation and framing of issues for the next phaseExecutive SummCritical analysis of Primal-)' Health Care Strategy implementationJudith Smith, Ministry of Health. March 2009Critical analysis of the implementation critical-analysis-primary-health-care-strategy-sept09ndertaken by Judith Smith. Visiting Academic Fellow in the Sector Capability and Innovation Directorate of the Ministry of Health during 2008-2009. The project's two elements were as follows:-an initial phase entailing critical synthesis and analysis of PHCS implementation to date and a framing of t critical-analysis-primary-health-care-strategy-sept09he key issues that faced this sector in 2008 and beyond; and-a second phase that sought to identify options for how primary health care provider develcritical-analysis-primary-health-care-strategy-sept09
opment might go forward in New Zealand .This paper is based on synthesis of existing analysis of the Primary Health Care strategy (the strategy) and iCritical analysis of Primal-)' Health Care Strategy implementationJudith Smith, Ministry of Health. March 2009Critical analysis of the implementation critical-analysis-primary-health-care-strategy-sept09ere undertaken in order to explore the background to, implementation of, and progress associated with the strategy.The Primary Health Care strategyThe Primary Health Care strategy was based on two core academic traditions within primary health care research:-the importance of strong and effective pe critical-analysis-primary-health-care-strategy-sept09rson-focused primary health care service provision as the crucial level for care continuity, co-ordination and integration within a health system (aftcritical-analysis-primary-health-care-strategy-sept09
er Barbara starfield, 1998)-the importance of primary health care as a fundamental approach to health and community development, and hence in reducingCritical analysis of Primal-)' Health Care Strategy implementationJudith Smith, Ministry of Health. March 2009Critical analysis of the implementation critical-analysis-primary-health-care-strategy-sept09h Care strategy, the focus on a health development paradigm of primary health care was predominant as the organising principle for the strategy and its implementation. This made great sense given the problems that the Strategy was seeking to address in relation to inequalities in health, in access t critical-analysis-primary-health-care-strategy-sept09o2Critical analysis of Primary Health Care Strategy implementationJudith Smith, Ministry of Health, March 2009primary health care services, and a needcritical-analysis-primary-health-care-strategy-sept09
for greater community participation in health.It is argued here the starfield vision of ensuring strong and comprehensive primary care services basedCritical analysis of Primal-)' Health Care Strategy implementationJudith Smith, Ministry of Health. March 2009Critical analysis of the implementation critical-analysis-primary-health-care-strategy-sept09egy implementation that was apparently intended. This assertion is made not on the basis of how funding has been allocated (for the majority of new primary health care funding has gone towards reducing the cost of access to first-contact care) but rather in relation to how the strategy has been impl critical-analysis-primary-health-care-strategy-sept09emented (e.g. the ways in which it has been able to engage and influence general practice and other providers), and where the most impact appears to hcritical-analysis-primary-health-care-strategy-sept09
ave been made (e.g. in reducing the cost of access to services, but not being able to lever significant change in models of care at practice and proviCritical analysis of Primal-)' Health Care Strategy implementationJudith Smith, Ministry of Health. March 2009Critical analysis of the implementation critical-analysis-primary-health-care-strategy-sept09o access such care), with timely access to in- and out-of-hours services, longer consultation times, and a sense of involvement in care decisions. This suggests that New Zealand has a strong base of primary health care provision upon which to build as it seeks to extend its primary health care servi critical-analysis-primary-health-care-strategy-sept09ces in line with Starfield's vision.Reflecting on implementation of the Primary Health Care strategyThe Strategy was, by its own admission, intended acritical-analysis-primary-health-care-strategy-sept09
s a vision to be interpreted locally, rather than a detailed national implementation plan. Progress made in relation to the six key directions set outCritical analysis of Primal-)' Health Care Strategy implementationJudith Smith, Ministry of Health. March 2009Critical analysis of the implementation critical-analysis-primary-health-care-strategy-sept09ding the foundation for activity focused on reducing health inequalities and improving public health. Likewise, 80 primary health organisations (PHOs) have been put in place and almost all of the population is registered with a PHO. However, the extent to which the population is aware of PHO functio critical-analysis-primary-health-care-strategy-sept09ns and services as suggested in the strategy is open to question, and it seems that people continue to relate first and foremost to their general praccritical-analysis-primary-health-care-strategy-sept09
tice or community provider. PHOs have involved communities in their governance arrangements and are clear about their responsibility to work with commCritical analysis of Primal-)' Health Care Strategy implementationJudith Smith, Ministry of Health. March 2009Critical analysis of the implementation critical-analysis-primary-health-care-strategy-sept09available to them to bring about3Critical analysis of Primal-)' Health Care Strategy implementationJudith Smith, Ministry of Health. March 2009Critical analysis of the implementationGọi ngay
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