The 2017 Primary Health Care (PHC) reform in Greece: Improving access despite economic and professional constraints?

Between 2010 and 2018 Greece was subject to a bailout programme by international creditors and three successive Economic Adjustment Programmes (EAP). These involved large-scale austerity measures and drastic reductions in public sector spending including healthcare. Within this context and in line with the international best practice guidelines for primary care, in August 2017 the left-wing SYRIZA government passed a law for the reform of the Primary Health Care (PHC) sector. The reform introduced the establishment of Local Health Units and the embedded notion of the ‘family doctor’ as the first pillar of healthcare provision. These reforms aimed to strengthen primary care and to improve access to publicly provided primary care services. Despite the promising claims, the reform was a subject of criticism and failed to engage key stakeholder groups and to be delivered within the original timeline. The aim of this paper is to present the chronicle of the reform, its current status at a national level and its implementation challenges. To address current implementation hindrances, the reform of the Greek PHC sector is expected to undergo systemic changes, including factoring in the scheme's funding needs after 2021, with the successive government reconsidering its future form.