Primary care – the kind delivered by general practice (GP) clinics – is the backbone of every health system. When it works, we barely notice it.

It keeps people healthy, detects problems early, coordinates care and keeps people out of hospital.

But across many high-income countries, despite very different health systems, primary care is under unprecedented strain.

Our recently published paper presents case studies from the United Kingdom, the Netherlands, Canada, the United States, Australia and New Zealand.

All show governments are leaning on primary care to solve increasingly complex health needs. At the same time, bureaucracies are demanding more documentation, compliance, performance metrics and administrative work.

However, very little new investment is going into the four parts of primary care that matter most:

continuity: seeing the same health provider over time, rather than pinballing from one specialist to another

continuity: seeing the same health provider over time, rather than pinballing from one specialist to another

comprehensiveness: getting the whole family’s physical, mental and social health care from one place

comprehensiveness: getting the whole family’s physical, mental and social health care from one place

coordination: ensuring all the different people and services involved in a patient’s care work together smoothly, information is shared and roles are clear, so patients don’t fall through the cracks

coordination: ensuring all the different people and services involved in a patient’s care work together smoothly, information is shared and roles are clear, so patients don’t fall through the........

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