Future development of primary medical care in New Zealand: a view from general practice.

The primary health care committee's activities should be the starting point for a real change in direction of government-supported health care. It must endeavour to start a real and continuing dialogue between providers, planners and consumers. This should be at both central and local levels--its theme should be flexibility. Effort must be put into progressively reorientating medical education by using the material and energy available in primary medical care at both undergraduate and postgraduate levels. An active exploration of alternative methods of funding and delivery of care should take place, all being continuously evaluated. Increasing emphasis on primary medical care is so much more cost effective than our present system that health funds must be urgently redirected to facilitate this move. Any decrease in funding will be short-sighted and put off real economies and future improvements in medical care. Funds for primary medical care must be increased; in the present situation this may mean by diversion from those at present allocated to hospital boards. This should be used to: (a) increase GMS as a holding exercise; (b) fund educational suggestions; (c) fund research suggestions; (d) fund formation of local primary health care committees and their planning activities; (e) supply costs of supportive practices; (f) support more extensive dialogue centrally between NZMA, Health Department etc and locally with health services development as seen in the recent SACHO exercises.