Primary health care led NHS: learning from developing countriesBMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7010.891 (Published 07 October 1995) Cite this as: BMJ 1995;311:891
- Paul Johnstone,
- Isobel McConnan, Senior registrar in public health, Director
- Buckinghamshire Health Board, Aylesbury, Bucks HP19 3DX
- International Health Exchange, London WC2E 9NA
Over the past 30 years a wide range of developing countries have successfully developed a model of primary health care promoted by theWorld Health Organisation. This is based on the idea of “essential health care based on practical, scientifically sound and socially acceptable methods and technology, made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain.”1 2 It differs fundamentally from the primary care system in the United Kingdom, which relies more on technical and curative care than the community oriented approach. Many Western countries, including the United Kingdom, are now, however, shifting their policies to strengthen primary health care,3 and there could be lessons to be learnt from the achievements of developing countries.
In the 1950s and ‘60s many developing countries faced a daunting task. Economic recession meant that many could not even start to emulate the West's medical model of health based on hospital medicine and high technology. A different model of care emerged, which recognised that the health of populations was determined by factors other than medical care and that …