ABSTRACT
Non-governmental public action is a critical component. Communities play a larger part in the executive functions than previously, but in very different ways in very different places: a spectrum stretching from commercial to charitable representation. And, on all fronts, these organisational developments are more open to international influences, through globalisation, than ever before. The simple forms of hierarchic bureaucracy or peer-based partnerships are inadequate, seem to be rapidly passing away and can no longer apply to future developments. In each country, a minimum of two national policy leaders and two local representatives of exemplar organisational developments in primary care were normally the subjects of semi-structured interviews using the same topic guide for transferable learning. For primary care this is said to mean 'new ways of meeting patients' needs', 'new flexibilities', 'a wider range of providers including independent sector organisations' and 'an enhanced range and quality of services'.
