The Vital Link: generalist clinical discipline in a world of health care markets and strategic planning

Abstract

Most countries have no clear, strategic vision of their health services despite the massive budget involved; only poorly controlled and unplanned growth. In Wales for the first time an attempt is being made to tackle the problem of strategic planning. They identified priorities and spelled out what they want to achieve for the people of Wales in health terms. This has become a field trails on a national scale to change the face of health service by using explicit strategic planning methods motivated by managers. This has to be implemented in a flexible way into the practical world of clinicians and patient needs. They are using the concept of "overall-health-gained" to aim at adding years to life and life to years. As a vital link and gatekeeper, the GP also needs to be involved in strategic planning where he can guide decisions into the direction where they will deliver people-centred health gain. He can be the advocate and helper for the patient who is lost in a maze of specialties and all kinds of health therapies offering themselves to the patient. Translating these underlying methods and principles of the Welsh trails into a less developed South Africa, promises far more, far quicker and far more dramatic gains than the equivalent in Europe.