Purchasing Primary Health Care Provided in General Practice

Foreword

The vast majority of us visit a doctor or health centre at some time to deal with a health problem that is worrying us. Some of us will need to make frequent visits, and the doctor may playa significant part in our lives.

These initial contacts with the health system are known as primary health care. However, few of us know the complicated funding and purchasing arrangements that underpin these consultations and how the arrangements have developed - particularly over the last 10 years. This report provides explanation and analysis of what the arrangements look like now.

As the basis for the report, we examined the historical development of state funding and purchasing of primary health care. We have found a great deal that does not meet our expectations - for example, we found ineffective needs assessment and monitoring and no strong accountability.

However, we do not see it as constructive to concentrate unduly on the past. Rather, we see our report as:

• a resource for people in the health sector - especially District Health Boards - that will help them understand the current arrangements and learn from the past; and
• a basis for future actions that are set out in our extensive recommendations.

Because public spending on health care is such a significant part of the Government's annual budget, it is a topic in which we will be taking a continuing close interest.

D J D Macdonald
Controller and Auditor-General

8 March 2002