Mental health. Past tense--future imperfect.
Experience from total purchasing sites suggests that commissioning mental health services in primary care will be difficult to achieve. Health authorities and trusts are concerned about maintaining adequate services for severely mentally ill people, who are rarely the focus of primary care innovations. Conflict between the competing priorities of primary and secondary services seems likely to remain. Evidence from total purchasing sites suggests it is more difficult to bring about change in mental healthcare than other services.
Lee
J
J
National Primary Care Research and Development Centre, Manchester University.
Gask
L
L
D002017:Budgets; D003220:Conflict, Psychological; D003284:Contract Services; D005194:Family Practice / Q000191:economics / Q000458:organization & administration*; D006291:Health Policy; D006292:Health Priorities; D006779:Hospitals, Public; D007400:Interprofessional Relations; D008605:Mental Health Services / Q000191:economics / Q000458:organization & administration*; D013222:State Medicine / Q000191:economics; D006113:United Kingdom