Earlier this year, the Department of Primary Care & Public Health at Imperial College hosted a visit from a delegation from the Ministry of Health in the Republic of Macedonia. During the visit, academics in the department discussed the primary healthcare system in the Republic of Macedonia and ways in which the Department of Primary Care & Public Health could support both undergraduate and postgraduate training in primary care. The Republic of Macedonia faces major challenges in improving its health system and the development of high-quality primary care services is seen as a key step in achieving improved access to healthcare.
NHS budgets are under considerable pressure. It is therefore unsurprising that many NHS Integrated Care Boards (ICBs) In England will aim to prioritise price in contract awards, But this approach is a significant threat to community-centred healthcare. While competitive tendering is a legally required, an excessive focus on costs in awarding NHS contracts risks overshadowing key factors such as established community trust, local expertise, and the long-term impact on continuity of care. This shift towards cheaper, often external, commercial providers threatens to cut the links between communities and their local health services. The argument that competitive tendering is solely about legal compliance, and not cost, is undermined by the very nature of such tendering, which by design encourages the lowest bid. This approach risks eroding the social fabric of local healthcare provision, where established relationships and understanding of specific community needs are essential. Establishe...
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