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Lessons for Australian primary care reform from New Zealand, that great change laboratory

Robin Gauld
Med J Aust 2011; 195 (4): . || doi: 10.5694/j.1326-5377.2011.tb03285.x
Published online: 15 August 2011

Will Medicare Locals represent a new layer of potentially ineffectual bureaucracy?

The Australian federal government is seeking to boost the role and organisation of primary care as part of a suite of health system reforms.1,2 Yet much of the all-important detail on what the primary care sector will look like, the shape new Medicare Locals (primary health care organisations that have the aims of supporting health professionals, improving primary care service delivery at a local level and improving access to after-hours primary care)3 will take, and how these new organisations will function remains to be worked through. New Zealand has a wealth of experience in primary care reform over the past two decades that Australian policymakers could usefully consider for lessons.


  • Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.


Correspondence: robin.gauld@otago.ac.nz

  • 1. Australian Government. Improving primary health care for all Australians. Canberra: Commonwealth of Australia, 2011.
  • 2. Australian Government. A national health and hospitals network for Australia’s future: delivering the reforms. Canberra: Commonwealth of Australia, 2010.
  • 3. Australian Government Department of Health and Ageing. Establishment of Medicare Locals and better access to after hours care. http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/factsheet-gp-01 (accessed Jul 2011).
  • 4. Malcolm L, Wright L, Barnett P. The development of primary care organisations in New Zealand: a review undertaken for Treasury and the Ministry of Health. Wellington: Ministry of Health, 1999.
  • 5. Malcolm L, Mays N. New Zealand’s independent practitioner associations: a working model of clinical governance in primary care? BMJ 1999; 319: 1340-1342.
  • 6. Gauld R, Mays N. Reforming primary care: are New Zealand’s new primary health organisations fit for purpose? BMJ 2006; 333: 1216-1218.
  • 7. Jatrana S, Crampton P. Primary health care in New Zealand: who has access? Health Policy 2009; 93: 1-10.
  • 8. Smith J. Critical analysis of the implementation of the primary health care strategy implementation and framing of issues for the next phase: a paper prepared for the Ministry of Health. Wellington: Ministry of Health, 2009. http://www.moh.govt.nz/moh.nsf/indexmh/implementation-strategy-phc (accessed Jul 2011).
  • 9. Gauld R. The unintended consequences of New Zealand’s primary care reforms. J Health Polit Policy Law 2008; 33: 93-117.
  • 10. Roland M, Rosen R. English NHS embarks on controversial and risky market-style reforms in health care. N Engl J Med 2011; 364: 1360-1366.
  • 11. Hill M, Hupe P. Implementing public policy. London: Sage Publications, 2002.

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