Corporatisation of primary care: the need for critical analysis

Corporatisation of primary care: the need for critical analysisAcross primary care, corporate actors are gaining influence, 1,2 which reflects a broad corporatisation of health care: "the general trend throughout the healthcare industry towards higher levels of integrated control by consolidated profit-seeking enterprises". 2This shift risks reshaping primary care from a relationship-oriented and community-oriented approach to a market-oriented and profit-oriented enterprise.Considering the publicly funded nature of primary care services in most countries, this development is particularly concerning and warrants both a critical analysis and an ethical and societal debate.Making a profit in primary care services is not problematic in itself; however, the practice becomes concerning when maximising profits is prioritised over providing highquality and accessible health-care services grounded in the core values and characteristics of primary care: 3 person-centredness, equity, professionalism, continuity, cooperation, and community-oriented and science-informed care. 4s new primary care ownership models with a role for corporate actors are emerging in different countries, it is important to consider what their possible contributions could be.First, by relieving clinicians of administrative and managerial duties, corporate actors can allow clinicians to focus more on patient care, thereby enhancing personcentred care. 5Second, centralised management could promote standardisation, thereby reducing unwarranted clinical variation and strengthening equity and scienceinformed care.Third, large corporate networks can potentially improve the financial stability of primary care practices through risk pooling and economies of scale, supporting continuity of care.Access to large financial resources can also enable investments in digital tools and diagnostics, further advancing innovation.Finally, corporate organisations can enhance equity of access by operating in underserved so-called medical deserts, especially when financial incentives are available.However, these potential benefits will only be realised if corporate actors act accordingly.Here, we highlight notable risks in giving space to corporatisation within primary care that warrant further investigation and, eventually, reconsideration.First, although clinicians are governed by professionalism and ethics, corporate actors have a first responsibility to shareholders.