Primary managed care in Europe

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7079.457 (Published 15 February 1997) Cite this as: BMJ 1997;314:457

Innovation by doctors is creating European health maintenance organisations

  1. Chris Ham, Directora
  1. a Health Services Management Centre, University of Birmingham, Birmingham B15 2RT

    Primary care is at the heart of the agenda for health policy in several countries. A recent management report from the Financial Times brings together information on the organisation and financing of primary care in five European countries and summarises government initiatives to strengthen primary care.1 As the report shows, primary care plays a bigger part in the health systems of Britain, Spain, and Italy than in France and Germany. Furthermore, there are many different approaches to organising primary care services and paying doctors. Government initiatives to move provision of health care to primary care include emphasising the gatekeeper role of general practitioners, developing the contribution of pharmacists as providers of primary health care, and using advances in healthcare technology to relocate services from hospitals to communities.

    Reflecting its origins and the focus of the publishers, the report concentrates particularly on the implications of these developments for the drug industry. These include the switch of products from prescription only medicines to over the …

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