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dc.contributor.authorBaum, Fran
dc.contributor.authorFreeman, Toby
dc.contributor.authorSanders, Prashanthan
dc.contributor.authorLabonte, Ronald
dc.contributor.authorLawless, Angela Patricia
dc.contributor.authorJavanparast, Sara
dc.date.accessioned2019-02-05T01:20:45Z
dc.date.available2019-02-05T01:20:45Z
dc.date.issued2016-09-09
dc.identifier.citationBaum, F., Freeman, T., Sanders, D., Labonté, R., Lawless, A., & Javanparast, S. (2016). Comprehensive primary health care under neo-liberalism in Australia. Social Science & Medicine, 168, 43–52. https://doi.org/10.1016/j.socscimed.2016.09.005en
dc.identifier.issn0277-9536
dc.identifier.urihttp://hdl.handle.net/2328/38896
dc.description© 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).en_US
dc.description.abstractThis paper applies a critical analysis of the impact of neo-liberal driven management reform to examine changes in Australian primary health care (PHC) services over five years. The implementation of comprehensive approaches to primary health care (PHC) in seven services: five state-managed and two non-government organisations (NGOs) was tracked from 2009 to 2014. Two questions are addressed: 1) How did the ability of Australian PHC services to implement comprehensive PHC change over the period 2009–2014? 2) To what extent is the ability of the PHC services to implement comprehensive PHC shaped by neo-liberal health sector reform processes? The study reports on detailed tracking and observations of the changes and in-depth interviews with 63 health service managers and practitioners, and regional and central health executives. The documented changes were: in the state-managed services (although not the NGOs) less comprehensive service coverage and more focus on clinical services and integration with hospitals and much less development activity including community development, advocacy, intersectoral collaboration and attention to the social determinants. These changes were found to be associated with practices typical of neo-liberal health sector reform: considerable uncertainty, more directive managerial control, budget reductions and competitive tendering and an emphasis on outputs rather than health outcomes. We conclude that a focus on clinical service provision, while highly compatible with neo-liberal reforms, will not on its own produce the shifts in population disease patterns that would be required to reduce demand for health services and promote health. Comprehensive PHC is much better suited to that task.en_US
dc.language.isoen
dc.publisherElsevieren
dc.relationhttp://purl.org/au-research/grants/nhmrc/535041en
dc.rights© 2016 The Authors. Published by Elsevier Ltd.en
dc.subjectAustraliaen
dc.subjectNeo-liberalismen
dc.subjectPrimary health careen
dc.subjectHealth promotionen
dc.subjectHealth equityen
dc.subjectSocial determinantsen
dc.subjectCommunity developmenten
dc.subjectManagerialismen
dc.titleComprehensive primary health care under neo-liberalism in Australiaen
dc.typeArticleen
dc.relation.grantnumberNHMRC/535041en
dc.identifier.doihttps://doi.org/10.1016/j.socscimed.2016.09.005en
dc.rights.holderThe Authors.en
dc.rights.licenseCC-BY-NC-ND
local.contributor.authorOrcidLookupBaum, Fran: https://orcid.org/0000-0002-2294-1368en_US
local.contributor.authorOrcidLookupFreeman, Toby: https://orcid.org/0000-0002-2787-8580en_US
local.contributor.authorOrcidLookupLawless, Angela Patricia: https://orcid.org/0000-0003-0718-8088en_US
local.contributor.authorOrcidLookupJavanparast, Sara: https://orcid.org/0000-0002-0388-5524en_US
local.contributor.authorOrcidLookupSanders, Prashanthan: https://orcid.org/0000-0003-3803-8429


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