A tale of two realities: how do policymakers and general practitioners perceive the performance of primary health networks in Australia

BACKGROUND: As the major regional primary health care (PHC) organisations in Australia, Primary Health Networks (PHNs) are expected to coordinate health care for patients and respond to local health needs. To evaluate their success, it is important to examine both policy practitioners' and GPs' perceptions of PHNs' role, structure and performance. METHODS: Thirty-six semi-structured interviews were conducted, including 15 interviews with policy practitioners and 21 interviews with GPs. The interviews were audio-recorded, transcribed and thematically analysed to gain a comprehensive understanding of key stakeholders' perceptions of the performance of PHNs. RESULTS: The interviews with policy practitioners gave rise to three main themes: (1) PHNs enabled federal and state collaboration in PHC; (2) PHNs played an intermediary role in system integration; and (3) further actions were needed to improve the performance of PHNs. Three further main themes were derived from interviews with GPs: (4) PHNs did not engage enough with general practice; (5) GPs preferred the former divisions of General Practice and distrusted PHNs; and (6) PHNs were viewed as a means for the federal health department to recentralise, rather than decentralise, the health system. CONCLUSION: The different sets of themes reflected different perspectives on PHNs' role, structure and performance. Although policy practitioners generally held a positive view over PHNs' role and performance, GPs complained about the lack of engagement from PHNs and demonstrated distrust of PHNs. Given GPs' critical role in the delivery of PHC, their distrust of PHNs limits the success of PHNs in terms of supporting better PHC and improving care coordination. The Australian Federal Government should find ways to mitigate GPs' distrust of Commonwealth-funded regional PHC organisations, including by encouraging improved engagement by PHNs with general practice.