The shift of care from hospitals and mental healthcare to primary care seems logical and necessary on paper. Closer to the patient, cheaper, and better organized. In practice, however, this transition turns out to be much more difficult. Healthcare professionals, organizations, patients, and governments get entangled in conflicting interests, scarcity of resources, and clashing visions. As a result, primary care risks becoming a plaything of policies and systems, rather than a strong pillar of the healthcare system.

Clashing interests in a changing healthcare landscape

The decentralizations are placing great pressure on primary care. Hospitals and medical specialists fear a loss of position and resources, while general practitioners and primary care organizations are facing increased responsibilities, workload, and uncertainty about their future. At the same time, patients are becoming more empowered and expect more control and transparency. What seems good for ‘the sector’ as a whole often proves unsustainable at the organizational and professional level. It is precisely there that the willingness to actively embrace change falters.

The core of the task lies not only in policy or funding, but in carefully managing interests at different levels: societal, organizational, and individual. Without explicitly weighing what parties stand to gain or lose, discussions remain stuck in viewpoints and emotions. By making interests visible and shifting the conversation from opinions to underlying motivations, space is created for joint solutions and the restoration of trust—between professionals, administrators, and patients.

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Director, Co-founder

Marc Wesselink