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Strategic purchasing will be a key lever for the system to be fit-for-purpose. Strategic
purchasing and commissioning will enable resources to be allocated to where they could be
better utilised to meet system goals and population needs, and achieve recalibration of the
public-private mix while simultaneously improving effectiveness and efficiency of the
healthcare delivery system. It is fundamental for the mechanisms of strategic purchasing to
be an integral function of health system governance, aligned with system strategic goals and
examined at all three levels of the health system: macro- (health system), meso- (purchaser-
provider healthcare delivery), and micro- (person journey of healthcare delivery) levels.

5.1.2 A PRIMARY CARE-LED INTEGRATED CARE SYSTEM

Recognising that conventional care models are no longer sufficient to address burgeoning
healthcare needs globally, the WHO has called for a “fundamental paradigm shift in the way
health services are funded, managed and delivered” to achieve further gains in health
outcomes (WHO, 2015b). In response, Our Hong Kong Foundation’s 2018 report
Fit for Purpose: A Health System for the 21st Century advocated for the reorientation of
Hong Kong’s health system from being hospital-centric and treatment-focused to
integrated and primary care-led to be fit for purpose. In particular, we recommended
accelerating the pace of primary healthcare (PHC) development which is acknowledged by
the WHO as a critical milestone in progression towards universal health coverage (UHC),
an orientation for health systems to enable access to needed healthcare for all individuals
regardless of individual capacity to afford care (see Chapter 1) (WHO, 2017b, 2019b).
In Hong Kong’s context, primary care is a crucial component of integrated care.

Our report reiterated the importance of primary care provision that is comprehensive,
coordinated, continuous, accessible, and connected with hospital and specialist care in an
integrated service delivery system enabled by a multidisciplinary team of primary
healthcare professionals. Under an integrated care model, prevention, treatment and
rehabilitation are provided by multidisciplinary teams under the primary and community care
hubs which also connect individuals to the social care they need (Figure 5.1). The teams
build links between stakeholders to ensure the best use of resources available and provide
continuity of high-quality holistic care across the fissures of service provision. These linkages
form networks between public and private service providers, and also medical and social
sectors. Providers of specialist and hospital care will also be linked with each other and also
with primary care providers. The integrated care model will promote integration between
medical services providers like primary care doctors and allied health professionals, and
community services providers like non-governmental organisation workers, forming a
sustainable continuation of healthcare services.

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