LEADING IN HEALTH CARE

Leading In Health Care

Leading in Health Care

1.0-INTRODUCTION:

The term primary health care (PHC) is commonly interchanged with primary care (Wass, 2000; Swerissen 2000) as if their philosophies and practices were the same. Similarly, the term health promotion is often substituted for health education especially in the general practice environment. Primary health care is both a philosophy and a system response to reducing health inequities and ameliorating the effects of disadvantage but primary care reforms seem to have little to do with the increase in concern about health inequities (Ham 2000) as primary care is drawn from the biomedical model, practised widely in nursing and allied health but general practice is the heart of the primary care sector. It aims to target individuals regarding disease prevention, early diagnosis and treatment. There is not much to address the socio-environmental and behavioural factors that underpin disease proliferation while practicing in a vertically designed medical model of primary care. However, these deficiencies are mitigated by PHC, which is a strategy of public health, derived from the social model of health and sustained by the Alma Ata Declaration, (WHO, 1978). Further to it there is co dependency of PHC and health promotion as both operate to change the social, political, environmental and economic determinants of illness in order to create better health in communities, regions or cities. This all cannot be achieved without truly implementing PHC whose organisation (and hence management) is different from conventional health care. Therefore it is problematic that primary care managers are increasingly provided with funds designated as PHC funding because it narrows the primary health care agenda and is symptomatic of a conservative environment that reflects serious policy moves away from comprehensive notions of PHC. Thus, implementation of PHC means organisation, improvement and maintenance of PHC services while securing its peculiar culture but this need various multifaceted mandatory skills of PHC management services. In this paper author tries to discuss the few of the compatible management skills to implement best PHC practices. The discussion focuses not only on the important managerial skills but also throws light on the peculiarities of PHC management as it will provide a good understanding why practices in PHC are not straightforward and may conflict with conventional management theories. The principles of PHC include equity on the basis of need; affordable access to needed services, the sustainability of health promoting services, empowerment of people alongside efforts to help them be more self-determining. In other words, a PHC service operates on social justice principles. So it becomes evident that the skills of PHC management should be based on its principles that are different from other forms of managements.

General practitioners and other primary care managers are being encouraged to practice PHC, as if it were a straightforward matter to become a skilled PHC manager. There does seem confusion about the essential differences between these fields of management but why does it matter? It matters because the trends in health status that demonstrate increasing health inequities are disturbing ...