TY - JOUR T1 - Steps towards more integrated care in New Zealand: a general practice perspective JF - BJGP Open JO - Br J Gen Pract Open DO - 10.3399/bjgpopen17X100845 SP - BJGP-2016-0850 AU - Les Toop Y1 - 2017/03/14 UR - http://bjgpopen.org/content/early/2017/03/13/bjgpopen17X100845.abstract N2 - The imperative to better integrate health care in New Zealand started a quarter of a century ago and has accelerated in recent years, some of it recently showcased at the 4th World Congress on Integrated Care in 2016.1 There exist mature models of horizontal integration, patchy examples of effective vertical integration, and much talk from the highest levels of government of the need for more intersectoral integration. The concept of improving horizontal integration by co-location and collaboration is of course far from new, with many and varied primary care workers in New Zealand expressing the wish to develop closer working relationships in the 1990s.2 These collaborative sentiments were not always shared by national disciplinary leaders and politicians.3 The integrated family health centre or healthcare home model with innovative models of care is only now gaining momentum in parts of New Zealand4, but is yet to be trialled and evaluated at scale.In the 1990s, competition in health was enshrined in policy by a hard-line, right-wing government with public hospitals rebranded as 'Crown Health Enterprises'. They were instructed to compete against each other and to deliver profits.5 Meanwhile, general practice was organising itself into collaborative independent practice associations (IPAs) to share after hours care, to negotiate collectively, to take back control of their own continuing education, … ER -