GENERAL-PRACTITIONER FUNDING POLICY - FROM WHERE TO WHITHER

Six public policy objectives relating to general practitioner (GP) fun ding since 1938 have been identified. They concern national health ins urance, rural GP shortages, care for the poor, health promotion, cost effectiveness and community control. Each of these objectives is exami ned in turn, focusing on the extent to which each has been met. In all cases past policies have been, at best, only partially successful in meeting their objectives and have required little in the way of disman tling prior to the introduction of new GP funding initiatives subseque nt to 1993. Theoretical principles relating to the development of effi cient and coherent public policy are discussed. New Zealand policy rel ating to funding of GP services has rarely conformed to such principle s. There is an emerging consensus between social democrats and liberta rians that targeted programmes for the poor is the equitable and effic ient way to proceed. A key policy decision concerns the balance betwee n planned primary care services for low income groups and more traditi onal market style arrangements for others.