ABSTRACT
Health authorities with responsibility for primary and secondary care came into being in April 1996. The new structure is the result of the changes announced in October 1993 which merged district health authorities and family health services authorities. The chapter describes clearly the changes, firstly for health authorities themselves and secondly for general practitioner and primary care. A main responsibility for health authorities is to purchase services of high quality. The health care programme approach takes a clinical area, e.g. the management of coronary heart disease, and considers what interventions might be carried out across the whole spectrum of health care. The challenge for new health authorities is to make decisions about priorities which are consistent across primary and secondary care. The process of purchasing health care is one of the main tasks of a health authority, increasingly being shared with primary care in a variety of different ways. The chapter concludes with an assessment of the challenges to be faced.
