Max Lee
Hume Whittlesea PCP
The Jerusalem
Effect
1978


WHO Alma Ata Declaration as the
seminal statement about primary
health care.
For the first time - notions of equity,
community involvement, needs and
standards = framing health care
services as tools and process for
achieving community well being.
1980- 1990’s
Throughout the 1990’s an international view
emerged focusing on the integration of social
and health services.
The new focus sought the following outcomes
•
•
•
•
•
•
•
efficiency;
user satisfaction;
better outcomes;
addressing cross-system care problems;
improving co-ordination of services;
ensuring better access to services; and
preventing cost-shifting. (Leutz, 1999, pp. 77-110)
1992 –1999
Kennett Liberal Victorian State Government
(1992 –1999) interpreted this view with a
strong focus on efficiency = delivering more
services, more cost effectively.
The Primary Health And Community Support
system, (PHACS) was the Government
strategic programme response and
established a unambiguous free market
approach to reform.
The PHACS Programme was part of a broad
state government agenda that preferred
larger community based agencies servicing
population catchments of 300,000 or more.
PHACS goals:
1.
2.
Compulsory service amalgamations and
restructuring to simplify the purchasing
process for government and to simplify
local government from the perspective of
the state.
Targeting of services to those communities
most in need, including a shift of funds
from metropolitan community health
services to rural and outer metropolitan
growth corridor community health services
2000 onwards


Change in Victorian state government in
October 1999 from Kennett to the Bracks
Labor State Government.
The PHACS redevelopment was reviewed by
Hayden Raysmith and then re-launched by
the Bracks Labor Victorian State Government
as the Primary Care Partnerships Strategy
(PCPS).
In 2000 the Primary Care Partnerships Strategy
aims were :
1.Inclusive of consumers and the community
(Consumers in prioritisation of health issues,
planning and evaluation roles).
2.Integrating service providers (Collaboration).
3.Focusing on social determinants of health (Risk
factors and reducing preventable illness).
4.Address the diversity of the Victorian community
(including cultural, ethnic, religious, linguistic
and rural and metropolitan specific needs).
5.Focussed on government’s role in planning, not
purchasing.
How ?
Community Public Health Plans (CPH) per
PCP catchment.
Community Health Plans were the regional
service planning and co-ordination tool and
provided the tool for defining and
managing service partnerships.
PCP’s were expected to lead Community Health
Plan development and the Plans were designed
to specifically focus on emerging ‘pillars’ :
1.Service planning (including health promotion
and integrated disease management).
2.Service coordination - coordinating local
infrastructure development such as
information management and referral.
3.Service partnerships - defining how the wider
partnership will implement the Community
Health Plan.
4.Consumers – a partnership approach to client
focussed service design.
Mid 2000’s
Highly dynamic changing policy and practice
environment – for example
1.
2.
3.
Service Coordination – SCTT driven PPPS
change, shift to proprietary based IT platforms
Connecting Care, S2S, Jadeware = cross –
product interoperability, ICT vertical integration
with Commonwealth, Services as ‘purchasers’
of proprietary software platforms.
Re-defining and re-discovering the Consumer
Collaboration ‘pillar’
Chronic Disease Alignment - Integrating PCP
ICDM with HARP Programmes and EiCD =
increased service complexity
“ The PCPS reform will only have a limited
impact if it becomes captured by a focus on
an administrative reform agenda.
Administrative reform in health service policy
and delivery is a necessary parallel but not a
substitute for genuine change in primary
health care delivery that provides measurable
improvements inequity, community
involvement and wellbeing.”
Merrian Oliver-Weymouth is a Policy Officer at Health Issues
Centre, 2001
References –
Health Issues, 2001, Number 67, pp. 28-32.1
Primary Care Partnerships: New Directions in Victorian Primary HealthCare
Merrian Oliver-Weymouth
http://citeseerx.ist.psu.edu/viewdoc/download;jsessionid=810E7335CD930B62AD472C626B77B564?doi
=10.1.1.130.5341&rep=rep1&type=pdf
Victorian Burden of Disease Study and its application to Primary Care Partnerships
Dr Theo Vos and Sylvia Barry