When contemplating writing a foreword to Dr Prabani Wood’s insightful report on primary healthcare, I felt a bit like an impostor. After all, I am a doctor, just not the medical kind. With my doctorate in law and master’s in economics, commenting on the finer points of healthcare seemed somewhat presumptuous.
Yet, during my discussions with Prabani over recent months, it struck me that the core principle she describes – ‘continuity of care’ – is remarkably familiar from everyday experiences outside of medicine. In fact, it reminded me of my car mechanic.
Since moving to Wellington, I have trusted Peter to service my cars. He specialises in European vehicles, knows exactly what I expect and understands my priorities. Once, Peter even anticipated an issue, ordering replacement parts without first consulting me, knowing that I would agree with his decision. And, of course, he was right.
Listening to Prabani explain the GP-patient relationship, it seemed that what she was describing was fundamentally similar. Such long-term relationships, built on mutual understanding and trust, are not unusual. They are common in successful business relationships, whether between mechanics and their customers or between companies and their clients.
Indeed, during my studies—particularly in marketing—we often discussed such relationships. Management theorists regularly invent buzzwords for this, referring to ‘customer integration’ or ‘co-production’. But the underlying principle remains consistent: recognising that good relationships, built on mutual understanding, deliver better outcomes.
So, if continuity of care is such a straightforward idea, why is it not more fully embraced in healthcare? This is the central question Prabani addresses. She clearly sets out the multiple benefits of robust GP-patient relationships: improved health outcomes, better preventative care and lower healthcare costs.
But equally, she examines why these relationships struggle to thrive under current conditions – highlighting systemic barriers including funding gaps, workforce attrition, fragmented IT systems and outdated healthcare models.
Her analysis brings to mind the principles behind Bill English’s social investment approach, pioneered when he was Minister of Finance. This approach emphasises early, targeted interventions driven by solid data and evidence, aiming to improve long-term outcomes and prevent problems before they escalate.
In healthcare, investing in strong GP-patient relationships represents precisely this kind of pragmatic social investment. Yet, to fully realise these benefits, we need better data and research. Prabani rightly notes how greater transparency and improved data collection could transform healthcare policy and delivery.
I am particularly struck by the innovative solutions Prabani highlights, such as the WHIRI Model of Care. This approach, which combines comprehensive health needs assessments with coordinated care between health workers, demonstrates how targeted interventions can bridge gaps between communities and healthcare services. Like Bill English’s social investment principles, these innovations focus on addressing problems early and efficiently.
Prabani’s report is an important and timely contribution. It clearly articulates why primary healthcare should be at the heart of our health policy debates. And as her report convincingly argues, primary care truly is the heart of healthcare.
I commend this thoughtful, evidence-based report to anyone interested in the future of healthcare in New Zealand.
