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Third sector primary care for vulnerable populations.

P Crampton1, A Dowell, A Woodward

  • 1Department of Public Health, Wellington School of Medicine & Health Services Research Centre, New Zealand. cramptonp@wnmeds.ac.nz

Social Science & Medicine (1982)
|November 17, 2001
PubMed
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Third sector primary care organizations, particularly Health Care Aotearoa, emerged significantly in New Zealand during the 1980s. These non-profit entities provide essential services to vulnerable populations, addressing gaps in government and private healthcare.

Area of Science:

  • Health Services Research
  • Public Health Policy
  • Sociology of Health

Background:

  • The third sector (non-government, non-profit) plays a crucial role in democratic, market-based economies by providing services neglected by other sectors.
  • Historically, third sector organizations offered social services in New Zealand, but their significant involvement in comprehensive primary medical care emerged in the 1980s.

Purpose of the Study:

  • To describe and explain the development of third sector primary care organizations in New Zealand.
  • To analyze the emergence and characteristics of organizations like Health Care Aotearoa.
  • To examine the policy implications of third sector involvement in primary care.

Main Methods:

  • Descriptive analysis of the historical development of third sector primary care organizations.

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  • Examination of the formation and structure of Health Care Aotearoa.
  • Review of international literature on third sector roles in healthcare.

    • Main Results:

    • Third sector primary care organizations, including union health centers, Māori health providers, and community clinics, became prominent from the 1980s.
    • Health Care Aotearoa, established in 1994, represented a significant network of these providers, focusing on non-European and deprived populations with population-based service approaches.
    • Their development aligns with international trends, often driven by perceived failures in government funding and private sector responses, leading to ongoing co-payments.

    Conclusions:

    • Third sector organizations provide a vital alternative for primary care services, especially for vulnerable populations.
    • The growth of these organizations reflects policy gaps and market failures in universal healthcare provision.
    • While potentially reducing state involvement, the reliance on the third sector raises concerns about equity and social cohesion due to a diminished welfare state role.