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CNA554 Primary Health Care 1

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  • Course Code: CNA554
  • University: University Of Tasmania
  • Country: Australia


The purpose of this essay is to enable students to gain insight into health and socio-political issues in aged care as well as evaluate and critique health service delivery for older people.


1. critique representations of older people in policy, laws and legislation, and health/social service delivery;

2. evaluate the rationales for resource allocation, service provision and coordination of services for older people using a social capital approach;

3. critique models of health service delivery for older people, including models of wellness, user-pays, case management, and active ageing (WHO).

In this essay you are required to critique primary health care for older people living in the community.



Primary Health Care (PHC) For Australian Elderly

Primary Health Care (PHC) is the essential healthcare based on the scientifically solid and socially acceptable methods and technology making UHC accessible to everyone in a community.  Ensuring full participation of community members and affordable cost of care ensures self-determination and self-reliance development. PHC approaches health beyond the conventional health system which focuses on health equity-yielding social policy. PHC include areas that play key roles in health like health services access, lifestyle, and environment. PHC and public health measures are jointly considered the cornerstone of universal health systems. The WHO defines the traditional goals of PHC based on three main categories. These categories include:

  • Empowering individuals and communities,
  • Multispectral policy and action
  • Primary care and essential public health

All the above three categories are central to integrated health services. PHC not only assist people after diagnosis with illness or condition but also prevent such issues by understanding a person in entirety.


Critique Primary Health Care for Old People

PHC services and support for the elderly living in the community has been generally successful through various support and services provided by commonwealth, state, territories, non-government support, and the volunteers (Oster et al., 2016). Most of these programs have, however, ignored the “healthy ageing” programs that lead to desired outcomes than those that focus on keeping the elderly in the residential and care facilities for extended period. Keeping old people in residential care facilities is not only costly, but also done against the wishes of the elderly people.  Old people prefer the community aged care packages. Plans are, however, underway for Australian to change policies that will adopt the new tendency that will save the cost of providing PHC to the elderly people and ensure they can remain active (Ahha, 2015). Active elderly people will be achieved through the stimulation and improvement of cognitive functioning (CF), physical activity (PA), nutrition, alongside better QoL. There have been noticeable shifts of focus towards community care rather than residential care.

The successive state and commonwealth governments have followed the overall policy framework of the “aging in place.” It puts more emphasis on keeping the old people and frail individuals in respective family contexts or homes as long as possible by providing homecare services (Wakerman et al., 2017). This is the best way to provide PHC for the old people. The full implementation of “aging in place” or “healthy” “aging or “I am Active”  should be hastened to help old people stay active members of the society instead of waiting until their health is deteriorated to be transferred into  residential care facilities against their wishes.

Thus, more focus should be given to such programs as “community aged care packages (CACPs), home and community care program (HACC), and extended aged care at home pilot (EACH)”. There is also a need for the Commonwealth government to check on the age discrimination and rights for effective PHC and also complete the development and implementation of desired legislations projected towards combating age discrimination challenge (Dawson et al., 2017). Such PHC strategies will improve the wellbeing of the elderly people. This is because the elderly people will not be forced away from their homes into residential care facilities. They will also remain active members of the society because it will diagnose any problem and solve it before affecting the elderly people.    


Explanation of primary health care for older people

Support and services provided to the Australian elderly people are offered through several programs by the government including Commonwealth, local, and territory or state. He old people also receive support or programs from communities and volunteers like carers and families. Private for-profit segment and private not-for-profits sectors also help the old people. Since elderly people are also accessed to the ‘mainstream” support and services. These include healthcare, income support, and housing support accessible to the entire population.  It is, therefore, quite challenging know precisely the services which are offered purely to the elderly people and at what particular costs (Rogers, Winterton, Warburton & O’Keefe, 2015). The elderly people receive various services and support when in need.  

Australian government does not see the need of offering specific support and services to old people below sixty-five-years (Gurwitz, Go & Fortmann, 2016). This is because these people have shown a general trend of living longer and healthier through mainstream assistance. Thus, the government only targets old people above 75 years to offer specific services and support. The need to assist an individual in Australia depends on his or her past life (Cooper et al., 2017).

In terms of policy, the older people will receive the best PHC if the Commonwealth government shift focus on early intervention and “healthy aging” and “aging in place” programs. This implies keeping the older individuals out of health and residential facilities for as long as possible. For instance, it cost commonwealth nearly thirty-thousand dollars every year for funding the average residential aged care bed as opposed to that of  CACPs which is about 10000$ a year. This shows that keeping old people in residential centers is cost-ineffective besides being against the wishes of the elderly people (McNamara, Rosenwax, Lee & Same, 2016).


Evaluation of the Way Resources are Allocated and Services are provided using a Primary Health Care Approach

The present government support can be discussed via the Commonwealth which offers various payments and supports particularly to the elderly of via the conventional programs accessible by the elderly. They included:

  • Acute care with states and territories
  • Aged pensions
  • Disability services with states and territories through the commonwealth-state or territory disability agreement operation
  • Hospital and home and community care support with states or territory and local government (Carroll, Reeve, Humphreys, Wakerman, & Carter, 2015).
  • Pharmaceutical alongside medical benefits
  • Public housing with the states besides territories through commonwealth-state housing agreement operation
  • Rent assistance alongside disability payment
  • Residential services including residential aged facilities alongside veterans’ residential faculties’ funding

Commonwealth further offers assistance besides support to old people’s carers, in terms of support payments (like the carer-payment alongside their allowances) as well as support services. For instance, funding for the respite centers besides resource centers of carers (Szoeke, Coulson, Campbell & Dennerstein, 2016). Commonwealth also funds various support services that indirectly or unswervingly assist and support the elderly. These include providing financial counselling and programs for health promotions, services for rehabilitation, and farmers’ retirement assistance. Other funded service include are advocacy services, consumer organization support and information related to the government’s programs. Much of the general spending of the Commonwealth in the areas of health, housing or accommodation and disability support goes towards the Australians aged above 65 years (Harvey & Kitson, 2015).  

The territory/states also provide various housing, welfare and housing services for the old people. Most states operate various residential aged care facilities as well as provide services and support usually in collaboration with funding from Commonwealth. These support and services include:

  • Carer assistance
  • Dementia support programs
  • Home help
  • Information services
  • Respite care
  • Transport assistance
  • Senior’s cards which enable on services alongside products’ discounts.

The municipal or local governments further provide a range of age-specific services and support funded by Commonwealth, states and territories. The local government provides a range of rate-relief level for the elderly pensioners. The local government also provide direct land management matters linked to health and aged-specific accommodations. They also provide such services as home help and senior citizen clubs operation (Richard et al., 2016).

The non-government support offer desired assistance to the aged people through a various support and services. Several aged-care residential facilities, support organization and programs for ‘aged care’ are run directly by charitable sector alongside community. NGOs funds nearly twenty percent of the services and support given to the elderly from their own sources of capital. Private-for-profit sector is also providing support and service to the old people, especially in respect of residential aged care and health services.   


Critical Discussion of Primary Health Care Service Delivery for Older People

The PHC for the elderly people is achieved through the funding from the Commonwealth, states and territory government and the non-government programs. These programs are being provided through a range of support and services. However, Australia has not fully implemented the program that keeps the elderly out of healthcare facilities and residential areas for a long period of time.  There is a need for all the stakeholders to adopt “healthy aging” and “aging in place” which proven to be successful. This will be achieved by tailoring the PHC programs towards the promotion of active/healthy aging in people aged sixty years and above. The stimulation and improvement of physical activity, cognitive functioning (CF), nutrition, and promoting better QoL help this program to achieve its goals of improving the wellbeing of the elderly people (NACA Blueprint Series, 2015).

This way, PHC will improve the wellbeing by ensuring that the funds are used to ensure equitable access to healthcare facilities. Thus, the funds must be used in a way that ensures that the elderly people can access these facilities early enough without being moved to residential centers against their wishes. The funds must also be used to promote the quality of life through increased community participation which brings together all the stakeholders including the government and non-governmental organizations, volunteers and other key stakeholders. Through this, the multispectral team can decide where to channel funds to ensure that transport system caters for the older people’s needs (O’Loughlin, Kendig & Browning, 2017). Also, funds can be channeled to schools and education system where everyone is taught on best practices to care for the elderly people. The funds can also be used for development of physical fitness facilities where the elderly can be assisted to remain active and healthy as they age.

The specific goals of this program include stimulating and improving PA, encouraging and promoting healthy eating behaviors, and improving functioning memory, alongside processing pace.  The objective of this program is effective and indeed specific to ensuring efficient PHC for the aging. Studies have proved that “I am Active” program promotes improvements in the active aging dimensions of PA, nutrition and cognitive function and also improving the QoL in healthy elderly. Mendoza-Ruvalcaba & Arias-Merino (2015) have proven this fact. Another weakness in the present programs and support given to the elderly is that Australian has raised the beneficiary age to 75 years. However, this age should be lowered to capture the age of sixty. When Commonwealth, territory and state programs start taking using the concept of “I am Active” will help them achieve the goal of keeping people away from the residential facilities which are even costly as compared to the community aged care.


In conclusion, whereas different viewpoints exists regarding the impacts of aging on society over the coming years, it is doubtless that PHC policy adjustment is inevitable. The stakeholders including the Commonwealth, state and territory government alongside the non-government stakeholder must favor such programs as “I am Active” already started through the “healthy aging” and “aging in place” as this is a proactive strategy which will greatly help the elderly and reduce costs while serving the best interests and wishes of the old population. 



Ahha. (2015). Primary Health Networks and Aged Care Ahha Primary Health Network Discussion Paper Series, 7(1), 1-7.

Carroll, V., Reeve, C. A., Humphreys, J. S., Wakerman, J., & Carter, M. (2015). Re-orienting a remote acute care model towards a primary health care approach: key enablers. Rural & Remote Health, 15(3).

Cooper, A., Edwards, A., Williams, H., Evans, H. P., Avery, A., Hibbert, P., ... & Carson-Stevens, A. (2017). Sources of unsafe primary care for older adults: a mixed-methods analysis of patient safety incident reports. Age and ageing, 46(5), 833-839.

Dawson, S., Gerace, A., Muir-Cochrane, E., O'Kane, D., Henderson, J., Lawn, S., & Fuller, J. (2017). Carers' experiences of accessing and navigating mental health care for older people in a rural area in Australia. Aging & mental health, 21(2), 216-223.

Gardiner, F. W., Gale, L., Bishop, L., & Laverty, M. (2018). Healthy Ageing In Rural And Remote Australia: Challenges To Overcome, 12(1), 6-18.

Gurwitz, J. H., Go, A. S., & Fortmann, S. P. (2016). Statins for primary prevention in older adults: uncertainty and the need for more evidence. Jama, 316(19), 1971-1972.

Harvey, G., & Kitson, A. (2015). Implementing evidence-based practice in healthcare: a facilitation guide. Routledge, 13(1), 12-118.

McNamara, B., Rosenwax, L., Lee, E. A., & Same, A. (2016). Evaluation of a healthy ageing intervention for frail older people living in the community. Australasian journal on ageing, 35(1), 30-35.

Mendoza-Ruvalcaba, N. M., & Arias-Merino, E. D. (2015). “I am active”: effects of a program to promote active aging. Clinical interventions in aging, 10, 829.

NACA Blueprint Series. (2015). Enhancing the quality of life of older people through better support and care, 12(1), 1-11.

O’Loughlin, K., Kendig, H., & Browning, C. (2017). Challenges and Opportunities for an ageing Australia. In Ageing in Australia. Springer, New York, NY, 12(2), 1-10).

Oster, C., Henderson, J., Lawn, S., Reed, R., Dawson, S., Muir-Cochrane, E., & Fuller, J. (2016). Fragmentation in Australian Commonwealth and South Australian State policy on mental health and older people: A governmentality analysis. Health:, 20(6), 541-558.

Richard, L., Furler, J., Densley, K., Haggerty, J., Russell, G., Levesque, J. F., & Gunn, J. (2016). Equity of access to primary healthcare for vulnerable populations: the IMPACT international online survey of innovations. International journal for equity in health, 15(1), 64.

Rogers, M., Winterton, R., Warburton, J., & O’Keefe, S. (2015). Water Management and Healthy Ageing in Rural Australia: Economic, Social, and Cultural Considerations. Environment and Behavior, 47(5), 551-569.

Szoeke, C., Coulson, M., Campbell, S., & Dennerstein, L. (2016). Cohort profile: Women’s Healthy Ageing Project (WHAP)-a longitudinal prospective study of Australian women since 1990. Women's Midlife Health, 2(1), 5.

Wakerman, J., Humphreys, J., Wells, R., Kuipers, P., Entwistle, P., & Jones, J. (2017). A systematic review of primary health care delivery models in rural and remote Australia, 12(3), 1993-2006.

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