Pre-Primary Health Care

Pre-primary healthcare is the biggest change in our understanding of how personal healthcare is perceived and managed in the past 200 years.

Understanding our current medical systems and why we do what we do is the best way to understand why pre-primary healthcare has become so important and what impact it is having on our future health. 

The Crisis in Healthcare:

Our traditional medical care systems operate basically the same across the world. Primary health care is delivered within our communities by general practice doctors and other health professionals and then with specialised secondary services at hospitals with dedicated physicians, surgeons, and nurses as required.

What is radically different across the world is how that medical care is accounted for. Many western countries have public healthcare – the government pays, others have a combination of public and paid services and some have limited or restrictive public services.

This has created a number of issues. In large populations where this occurs, healthcare is not equitable and becomes a major factor as to how people live day to day. There is much more that could be said but it would do little to change the structures that have been built over many years with considered self-interests and governments unwilling or unable to change the status quo. 

This alone has not created a crisis in healthcare. What is now pushing our current medical structures to the point of breakdown is the impact of the SARS Covid virus, how it has been managed, and now how its effects will be mitigated.

• Post Covid conditions are getting little to no attention so their impact on our future health and our healthcare systems is unknown. Relaxed quarantine rules will directly correspond to more infections and it will be deemed endemic and reported amongst other viruses such as the flu. This approach whilst “textbook” will not manage the long-term conditions being seen.
• The level of primary care delivered by general practitioners is declining with many leaving the profession and fewer students choosing medicine as a career with other health professionals continuing to encounter long-standing workforce supply and well-being issues.
• For decades, innovation in healthcare has focused on modern industrial societies, prioritised technically-advanced hospitals with diminishing people-centered care. 
• Primary and secondary healthcare failures are being reported in many so-called “healthy” countries – Australia, the United States, the United Kingdom, France, Germany, China, South Korea
• Medicare mischarging, reductions in bulk billing availability, and overcharging have become a public issue with recent reports and fears for doctors’ safety

These issues are having a cumulative effect on our medical care systems – they are unable to cope, with wait times for many issues going from weeks to months or patients not being seen at all, placing people at higher risk. Obviously, if we were in a better state of health for the majority of our lives then the use of medical systems would be reduced, and ultimately the level and quality of care would improve and be able to cope with significant population health events. 

In some ways, this data is not new, even though it is reported every day. The World Health Organisation (WHO) has focussed on the delivery of equitable health since the mid-1970s.

The World Health Organisation:

The World Health Organisation (WHO) has a responsibility to provide guidance and on-ground support for all global population health matters. In 1978 the Alma Ata Declaration was signified by the 134 national government members with a consensus being that health was a human right based on the principles of health equity, person-centered care, and a central role for communities in health.

Over 40 years later a review was conducted to ascertain the success or otherwise of the intent of that declaration. Unsurprisingly, in a summary, the WHO stated that “the world has been unable to mobilise the resources and institutions needed to transform health leading to a significant gap between healthcare systems and the people they were designed to serve”. 

However, the Report represents an important opportunity to draw on the lessons of the past, re-confirm its objectives and consider the challenges that lie ahead.  

The original objectives continue to be universally agreed upon:

• The Conference strongly affirms that health, which is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity, is a fundamental human right and that the attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector.
• The existing gross inequality in the health status of our people, particularly between developed and developing countries as well as within countries, is politically, socially, and economically unacceptable and is, therefore, of common concern to all countries.
• That people have a right and duty to participate individually and collectively in the planning and implementation of their health care.
• Primary health care is essential health care based on practical, scientifically sound, and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford. It forms an integral part both of a country’s health system and of the overall social and economic development of the community. 
• An acceptable level of health for all the people of the world can be attained through better utilisation of the the world’s resources.

The updated recommendations are basically the same with greater consideration of the global impact of COVID and the massive breakdowns in primary and secondary healthcare systems over the past few years.  

Universal Coverage Reforms: ensure that health systems contribute to health equity, social justice, and the end of exclusion, primarily by moving towards universal access and social health protection; 

Service Delivery Reforms: re-organize health services around people’s needs and expectations, so as to make them more socially relevant and more responsive to the changing world, while producing better outcomes; 

Public Policy Reforms: that secure healthier communities, by integrating public health actions with primary care, by pursuing healthy public policies across sectors and by strengthening national and transnational public health interventions; and

Leadership Reforms: replace disproportionate reliance on command and control on one hand, and laissez-faire disengagement of the state on the other, with the inclusive, participatory, negotiation-based leadership indicated by the complexity of contemporary health systems. 

Expectations are that we will continue to have a “health care crisis” so each of us needs to consider our approach to personal health care and personal health knowledge.

Moving Forward:

Our global community has 8 billion members at last count, all seeking health care when required in a seemingly chaotic and inequitable world.

People are increasingly impatient with the inability of health services to deliver levels of coverage that meet stated demands and changing needs and now have little choice but to accept that the notion of available and effective primary health care will become a historical reference.

The path forward will not improve unless we all take steps to improve our own personal healthcare and health knowledge. To do this we must use and rely on digital technology to navigate to a position of strength where we are able to control our health destinies.

Universal Digital Health Coverage:

The overwhelming factor allowing global communities access to pre-primary healthcare and knowledge is the widespread availability of mobile phone and data services. 

These services are widely available in our cities and urban areas and are now being made available in some of the most remote locations on our planet where they have been critically needed. This proliferation is providing a viable and consistent means to deliver global population access to attainable, baseline health assessments via a mobile phone.

Giving People Confidence in Health Care Systems:

The evidence from numerous studies is that people are more willing and able to care for themselves if they are confident, reassured, and certain of support. Studies from around the world demonstrate that close to 75% of all primary care consultations are appropriate for self-care and resulted in health professionals providing little more than reassurance, information or non-prescription drugs.

The most effective way to reduce the load on our primary care system is to reduce the number of people being seen. The only way to do that is for people to take greater and more informative responsibility for their future health. 

We didn’t create the pre-primary healthcare sector, it has always been there, rather we are helping to define its functionality along with many others around the world.

Our goal is to be to be the leading provider of predictive analytics for personal healthcare management. We know it will take many years to have the impact we would like but supporting the pre-primary healthcare sector and partnering with people that want to have healthy predictable lives helps us to know that we can achieve that outcome.