Strengthening general practice will save lives, researcher argues

In his new book Primary Health Care and Population Mortality, released next week, Professor Richard Baker draws on international evidence to show how primary health care is key to the effect of health systems on population mortality and inequality in mortality. His conclusion is that it is time to think about primary health care in a new way.

He explains: “It is as if policymakers think primary health care is little more than a triage mechanism for the health system, that its purpose is to manage access to other health sectors that have the expertise and expensive technology needed to improve health and save lives. But primary health care is more than a triage system.”

In contrast, Professor Baker argues that primary health care should be seen as “that part of the health system that has a powerful influence on population mortality”.

How to strengthen primary health care

Professor Baker is a researcher specializing in UK health care and has carried out an extensive review of research to show that primary health care plays a key role in reducing death rates.

The findings are brought together in a list of 23 mechanisms that explain how primary health care affects mortality.

These include funding and sufficient staff, access for all sections of the population and equitable onward access to specialist care when needed, comprehensive care for everyone including mothers and children, disease prevention, early diagnosis, the management of chronic disease, and a relationship with patients that builds trust and confidence.

“These mechanisms provide a framework for strengthening global health systems,” Professor Baker explains. “It is time for the leadership of health systems, for policymakers and governments to look beyond the immediate challenge of helping services recover from the pandemic.

“The focus should be on the creation of primary health care services that reduce population mortality and improve health equality.”

Life expectancy in the UK

Life expectancy in the UK is falling behind that of comparable countries, but in his new book, the 23 mechanisms identified by Professor Baker provide a framework for restoring general practice in this country.

These include increased funding allocated according to the needs of local populations, determined policies to reverse the decline in GP numbers, and improvements in access and continuity.

He continues: “Active steps are also needed to reduce inequalities in healthcare for different communities.

“This should include outreach services for specific groups and addressing the hurdles many people encounter when seeking access to primary health care or referral to specialists.”

Health care for children

A key message in Professor Baker’s book is that helping all children have a healthy start in life must be part of the process.

He explains: “Improved health care provision for children not only helps to prevent childhood deaths but lays the foundation for long-term health.

“National policies to strengthen primary health care and build collaboration between primary, secondary and social care for children could make a lasting difference.”