Governance of primary care is a key issue.
The co-operative governance of primary level health services requires structures and processes for co-ordination and collaboration between the two organizations.
In China, governance of primary care appears fragmented between a plethora of different state bodies, which results in fragmented implementation of policy and, for example, differing levels of coverage and access to health care by different insurance schemes.
Governance of the primary care sector in Japan is characterized by a loose structure that exists between clinics and hospitals.
Previous studies in Europe and internationally determined the strength of a primary healthcare system according to its performance in relation to: a) primary care structure (governance, economic conditions of primary care system, workforce development) and b) the services delivery process (access to PC services, comprehensiveness of PC services, continuity of care, coordination of care) [ 22, 23].
Framework analysis, based on the Normalisation Process Model (NPM), of attempts over a five year period to develop clinical governance for primary mental health services in Primary Care Trusts (PCTs).
As Europe is facing unprecedented social, economic, demographic and epidemiologic transitions, the discussion on the structure and governance of health care systems is of primary importance as major influences on self-management support infrastructures and processes.
To populate those parts of an NPM-based analytic framework, this study draws on a programme of research carried out over a five year period into the implementation of clinical governance in Primary Care Trusts (PCTs) in England.
Comparing the above findings with the much greater impact of clinical governance in better-evidenced areas of care such as coronary heart disease [ 28], suggests that such a policy commitment would probably be the biggest single policy contribution to increasing the impact of clinical governance in primary mental health care.
There was a range of governance structures of the primary health care services that participated in the interventions.
If the law is to be accessible and intelligible, for example, then there must be an end both to judicial prolixity and to what Bingham calls "the legislative hyperactivity which appears to have become a permanent feature of our governance - in 2004, some 3,500 pages of primary legislation; in 2003, nearly 9,000 pages of statutory instruments".
