In recent times, many developing countries have been going through a process of re-orienting health policy and services towards early detection and prevention, rather than solely on the treatment and on-going management, of illness and disease.  For example, in the UK, the fundamental philosophy underpinning the approach to funding primary healthcare is analogous to the adage ‘prevention is better than cure’, with the NHS Improvement Plan stating that “If England is to secure world-class standards of health, the enormous human, financial and physical resources available to the NHS need to be focussed on the prevention of disease and not just its treatment”.¹  Within Australia, there are similar shifts in thinking and policy, with the development of the National Preventative Health Taskforce ², which has been tasked with developing a National Preventative Health Strategy.

Given this shift on emphasis, this paper has been written as a mechanism for synthesisng the evidence on the benefits of investing in primary healthcare, in terms of reducing demand on hospital care, which obviously results in system reform.  By primary healthcare, I do not just refer to general practitioners (GPs), but more widely to multi-professional primary healthcare teams whose roles include promoting/ maintaining health and preventing illness, in addition to the additional roles of diagnosing/treating illness and referring (where necessary) to hospital care.  In addition, it is extremely important to acknowledge that primary healthcare (indeed, health care in general) cannot work alone in promoting health and preventing illness, and therefore, ultimately in reducing demand on hospital services.  The evidence provided in this paper refers almost entirely to the role of illness prevention programmes/interventions in primary healthcare (and some aimed at population health interventions) in reducing demand on hospital services, although there is also a great deal of evidence on the role of interventions in many other sectors (community, education, employment, transport, welfare benefits, urban planning etc) on promoting health and reducing the burden of illness.  This brings to the fore the importance of ‘joined up working’, ‘inter-sectoral’ and ‘whole of Government’ approaches to tackling the issues, in addition to the crucial importance of fully engaging patients, the public and communities.