ABSTRACT
This chapter presents the context for health workforce regulation and a thumbnail sketch of the demographic and epidemiological challenges facing primary health care. It is based primarily on the current situation in Australia. Health systems are going through a period of reform in primary health and community care whereby community-based allied health and nursing services could become more integrated with general practice medicine. The chapter examines the regional governance of primary health care and draws upon the author's own practice and research work with Australian colleagues on health system culture topics such as inter-professional learning and clinical logistics of chronic disease management. It then proposes a multilevel governance challenge for transforming the culture of the health workforce toward better chronic disease management, through a three-part approach. This involves supporting the shift of health service providers to becoming more sophisticated knowledge workers, the provision of clinical units with monthly quality of care performance information, and support for improved patient health literacy.
