Public health readiness and role in transformation to a community-based primary healthcare system.

Millar et al. provide a high-level vision for transforming primary care into a community-based primary healthcare system, arguing that public health involvement is critical to the success of this transformation. The authors discuss a number of approaches to mitigate challenges to public health's readiness to participate. In this commentary, the author addresses selected points encouraging the avoidance of high-level conceptual language, a focus on specific value-added linkages and addressing the complex range of critical success factors needed to effect this transformation.

Moloughney BW 《-》

Improving collaboration between public health and primary healthcare.

This paper responds to the ideas set forth by Millar et al. in their exploration of whether public health is ready to participate in the transformation of the healthcare system. In this commentary, the author proposes a number of novel solutions to address these challenges, categorized into four areas: experimenting with joint planning, using innovative ways to share and analyze data, employing joint training and networks and facilitating how primary healthcare engages in health promotion in the local community. The author asserts that, ultimately, no single solution will address the multiple barriers to collaboration, but the implementation of some of these ideas can move Canada forward in this area.

Pinto AD 《-》

Public health has got to want to participate!

The lead paper makes a clear case for why better linkages between public health and primary care are necessary in order to address the very significant challenges faced by health systems. Millar and colleagues observe that many public health professionals do not appear to be prepared to take part in the reform of the acute care system. But while Millar et al. provide some historical analysis of how this situation has come about, their article largely refers to recent history in Canada. In this commentary, the author presents a longer-term historical analysis and the experience of other countries to illustrate that there have been, and are, times and places with excellent links between public health and primary care.

Goel V 《-》

Transformational change: short-term gain for long-term pain?

Transformational change as envisioned by Millar and colleagues forecasts a closer relationship between public health and primary care. In this commentary, public health readiness and the fiscal feasibility of the suggested model are examined from a pragmatic perspective based upon past and current experience. In the face of finite resources and compelling evidence on the merits of public health retaining its traditional involvement with community partners, the utility of late-stage secondary prevention collaboration with primary care is queried. Pursuing partnerships motivated by alleviating pressures in the healthcare system may be superficially attractive but might have a long-term negative impact on the health of the overall population.

Stanwick R 《-》

Public health in health sector reform.

In this edition of Healthcare Papers, Miller et al. make the case for greater engagement of the public health sector in healthcare system reform. Although I agree with many of the points made, I challenge the premise that public health is unwilling and/or unprepared to lead or participate in system change. Ontario's public health sector is not only ready to participate in transformation of the healthcare system, provincial and local involvement is well under way. Public health has been actively engaging colleagues in both the healthcare and non-health sectors to discuss health system evolution and transformation. Make No Little Plans - Ontario's Public Health Sector Strategic Plan sets out the vision, strategic goals and collective areas of focus for the next three to five years, and includes an immediate emphasis on establishing collaborative mechanisms within the sector and with others in the health sector and non-health sectors. As an initial step, public health is identifying and analyzing key intersection points between public health and primary care to enable better alignment and integration. In Ontario, public health is not only participating in health reform, we are in a position to help drive it.

King A 《-》