title: Lessons from Albion: Can Australia learn from England's approach to primary healthcare funding?
abstract: OBJECTIVE
  As Australia struggles to meet increased demand for healthcare and contain expenditure there has been a focus on primary care and its role in demand management and keeping people out of expensive secondary care. However, with domestic policy struggling to find a suitable approach consideration of English policy could well be fruitful in the quest to strengthen and develop primary care in Australia. The purpose of this paper is to consider policy developments in England and explores these in relation to the Australian healthcare system.
  
  
  METHODS
  The authors highlight the key changes to policy that have occurred in the English healthcare system in recent years, and discuss whether they have proven successful. The authors discuss the barriers to implementing similar approaches in Australia, particularly the difference in system structure that would necessitate policy adaptation.
  
  
  RESULTS
  Whilst there are differences in the structure and organisation of funding and service provision between countries, there are developments in England that are worthy of consideration from an Australian perspective. These include a focus on funding and commissioning that rewards quality not just activity and volume. As Australia sees the development of new primary care organisations that are tasked with commissioning then developments and lessons around the technical and relational aspects will be important to consider.
  
  
  CONCLUSIONS
  The work highlights that Australia might consider learning from the English experience in this area and the types of incentives that may increase efficiency and quality of health service provision. This is important as it potentially gives greater certainty about those approaches most likely to yield beneficial outcomes for patients and the broader system.
authors.affiliation: School of Public Health, Curtin University, Perth, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Norman
authors.forename: Suzanne
authors.initials: S
authors.lastname: Robinson
mesh_terms: D001315:Australia; D003657:Decision Making; D003695:Delivery of Health Care / Q000191:economics*; D004739:England; D005380:Financing, Government; D019982:Organizational Case Studies; D011320:Primary Health Care / Q000191:economics*
keywords: Australia; Decision making; England; Government policy; Policy; Primary care