Abstract
Integrated care that substantively impacts population health as well as provides quality care requires buy-in, engagement and commitment over time by a plethora of government and community groups. There is considerable evidence of the complexity of care models that work such that long term commitment is required to truly impact health. These days, beyond work opportunities, most municipal government and community leaders realise that good quality health services are critical to retaining and recruiting residents, especially noteworthy as an issue in rural communities. How do places manage bottom-up, top-down tensions as politics and control issues intervene across differrent levels of government? What sort of governmental leadership inspires community engagement versus chronic frustration?
We can learn a great deal from these natural experiments in integrated care that inform process, outcome, and resource distribution. We can also discover critical dance (steps and mis-steps) between local sites of innovation and government in advancing or delaying the implementation of gold standard integrated care.
This submission introduces a fascinating case of the development of a community-lead integrated health centre and government's role in supporting as well as stonewalling implementation of this world-class concept. It will also show what's possible in terms of community commitment to design,resource, build, and operate this iconic integrated health centre. It will also raise a set of theoretical and methodological ideas that could advance research and evaluation in integrated care implementation.