The Primary Health Care Charter (the Charter) sets the direction, targets and outcomes to support the creation of a strong, sustainable, accessible and effective primary health care system in B.C. Primary health care provides firstcontact access for each new need, long-term comprehensive care that is patient-centred, and coordination when care must be sought elsewhere.

There is great potential in primary health care to improve the health of the population and contribute to the sustainability of the health care system. To reach that potential, all partners for a healthy population must work together. To support such collaboration, this provincial charter for primary health care was co-developed with many partners to capture the activity, experimentation and successes of the last five years, and to set strategic direction to move forward.

The work outlined in the Primary Health Care Charter supports the B.C. government’s Five Great Goals for a Golden Decade. The Charter describes primary health care challenges, identifies priorities, and establishes outcome measures to set the strategic direction of the Ministry of Health with the regional health authorities. Developing the Charter collaboratively has resulted in clear direction and priorities that each health authority will translate into its plans, and the Ministry of Health will use in developing its long-term integrated strategic plan for B.C.’s health care system. In addition, the Charter sets out a strategic agenda for other key stakeholders who want to align their efforts with a systems approach.

Currently, family physicians constitute the largest workforce in primary health care. Therefore, the current B.C. government/BCMA agreement (the Agreement) is a significant part of the Charter’s context. Components of the Agreement align with and support each of the Charter’s seven priorities outlined below. The Agreement also includes dedicated change-management funding. The Practice Support Program teams, funded through the Agreement, which include physician champions, will work in partnership with local family physicians and health authorities staff in realigning health care services to attain better health outcomes and improve providers’ professional satisfaction. The Agreement contains a planned investment in information management/information technology (IM/IT) for primary health care. IM/IT is critical to successfully implementing the Charter, and supports activities in the seven priority areas. To achieve measurable progress in each priority area, it is imperative for the health system to focus on a small number of high-impact, system-wide initiatives and achieve the desired system shifts and health outcomes. The infrastructure initiatives that support work in the seven priority areas include implementing integrated health network teams with patients as partners as the basic philosophy.

Achieving system-wide improvements in B.C. requires a multi-faceted strategy–no one solution will provide the kind of system shift we require to meet changing patient needs. When identifying solutions, we must take into consideration urban/rural realities, supply and skills of health care professionals, and public expectations and attitudes. Based on the analysis of existing challenges and strengths, the following seven priorities have been established:

1. Improved access to primary health care
2. Increased access to primary maternity care
3. Increased chronic disease prevention
4. Enhanced management of chronic diseases
5. Improved coordination and management of co-morbidities
6. Improved care for the frail elderly
7. Enhanced end-of-life care

These priority areas knit together with a focus on priority populations: maternity patients, people at risk for or living with chronic conditions, the frail elderly, people living with mental ill health and addictions, aboriginal people, and people approaching end-of-life.

Developing the Charter has supported and stimulated an exchange of information among a broad stakeholder group. The alignment of governmental and non-governmental strategic plans is an encouraging sign. It will facilitate implementation of the Charter and ultimately ensure its success.