definitions
Primary Health Care (PHC) incorporates personal care with health promotion, the prevention of illness and community development. The philosophy of PHC includes the interconnecting principles of equity, access, empowerment, community self-determination and intersectoral collaboration. It encompasses an understanding of the social, economic, cultural and political determinants of health.
Reference: Keleher H 2001. Why Primary Health Care Offers a more Comprehensive Approach to Tackling Health Inequalities than Primary Care. Australian Journal of Primary Health 7 (2): 57-61.
"A definition of PHC developed in Australia to suit the needs of this country is: Primary Health Care seeks to extend the first level of the health system from sick care to the development of health. It seeks to protect and promote the health of defined communities and to address individual and population health problems at an early stage. Primary health care services involve continuity of care, health promotion and education, integration of prevention with sick care, a concern for population as well as individual health, community involvement and the use of appropriate technology (Australian Health Ministers' Council 1988; Commonwealth Department of Health and Family Services 1988)".
Reference: Fry D, Furler J 2000. General practice, primary health care and population health interface. In: Commonwealth Department of Health and Aged Care 2000, General Practice in Australia: 2000. Canberra: Commonwealth Department of Health and Aged Care. p.388
Primary Care is more clinically focused, and can be considered a sub-component of the broader primary health care system. Primary care is considered health care provided by a medical professional which is a client's first point of entry into the health system. Primary care is practised widely in nursing and allied health, but predominately in general practice.
Reference: Keleher H 2001. Why Primary Health Care Offers a more Comprehensive Approach to Tackling Health Inequalities than Primary Care. Australian Journal of Primary Health 7 (2): 57-61.
Useful Resources
 Nursing in general practice
Divisions of General Practice
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Differences between comprehensive and selected pHC
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Comprehensive PHC |
Selective PHC |
Medical Model |
View of health |
Positive wellbeing |
Absence of disease |
Absence of disease |
Locus of control over health |
Communities and individuals |
Health professionals |
Medical practitioners |
Major focus |
Health through equity and community empowerment |
Health through medical interventions |
Disease eradication through medical interventions |
Health care providers |
Multidisciplinary teams |
Doctors plus other health professionals |
Doctors |
Strategies for health |
Multi-sectoral collaboration |
Medical interventions |
Medical interventions |
Reference: Rogers, W. & Veale, B. (2000). Primary Health Care: a scoping report. National Information Service, Dept of General Practice, Flinders University. p.18.
Position statements
1. Primary Health Care
World Health Organisation (WHO): PHC gained currency following the 1978 International Conference on Primary Health Care held by the WHO and UNICEF at Alma-Ata. The WHO's Declaration of Alma-Ata (1978) is a ten point statement identifying health as a fundamental human right, with primary health care described as the key for attaining health for all by the year 2000.
Australian General Practice Network (AGPN): released a Primary Health Care Position Statement (2005) outlining the Division Network's vision for the Australian primary health care system. In conjunction with the Australian Primary Health Care Research Institute (APHCRI), AGPN produced an accompanying monograph: Primary Health Care Position Statement: a scoping of the evidence.
Australian Medical Association (AMA): produced its Primary Health Care Position Statement - 2006 addressing issues such as primary care teams, access, advocacy, safety and quality, workforce, funding, after hours, preventive medicine, Aboriginal and Torres Strait Islander health, training, research and doctor health.
Royal College of Nursing Australia (RCNA) produced a Position Statement: Primary Health Care in 1999 briefly addressing the role of nurses in primary health care.
2. Primary Care
The Australian Government Department of Health and Ageing's response to the review of the role of Divisions of general practice in 2004, Divisions of General Practice: Future Directions includes information about the Government's priorities for advancing primary care in Australia. The response highlights that the "focus of Divisions should be to assist general practice to provide services to the community in a primary care system" (p.22).
Reference: Commonwealth of Australia. (2004). Divisions of General Practice: Future Directions. Canberra: Department of Communication, Information Technology and the Arts, Commonwealth of Australia.
Worth reading:
'Primary Health Care and General Practice: A Scoping Report' Published by the Primary Health Care Research & Information Service (Rogers & Veale, 2000)
This report:
- describes and defines both primary health care and general practice, highlighting the areas of overlap and the major philosophical and strategic differences
- identifies issues to be addressed in strengthening primary health care in Australia
- includes examples of both research and programs in the categories of medical model, selective primary health care and comprehensive primary health care.
'Why Primary Health Care Offers a more Comprehensive Approach to Tackling Health Inequalities than Primary Care' Keleher H, 2001. Why Primary Health Care Offers a more Comprehensive Approach to Tackling Health Inequalities than Primary Care. Australian Journal of Primary Health 7 (2): 57-61.
This article describes the differences between the terms 'primary care' and 'primary health care', the problems associated with using them interchangeably, and the strengths and limitations of each model, particularly in dealing with health inequalities, and argues the structures and practices of the primary care sector are not necessarily compatible with notions of comprehensive primary health care.
'Systematic review of comprehensive primary health care models' McDonald, J., Cumming, J., Harris, M., Powell Davies, G., & Burns, P. (2006). Canberra: Australian Primary Health Care Research Institute
This review examines primary health care models in Australia. United Kingdom and New Zealand, focusing on organisational structures, funding and the changing face of the primary health care workforce. A one and three page summary for the findings are also available.
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