The spatial and temporal organisation of primary health care services in rural areas : a case study of Wales

• Main Author: White, Sean D.
• Published: Cardiff University 2005
• Subjects: 361; H Social Sciences (General)
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.583576

The last ten years have seen major changes in the organisation and delivery of primary healthcare services in the England and Wales and this has had considerable implications for consumers of these services in rural parts of the country. This thesis seeks to explore the effects of these structural changes in the delivery mechanisms of primary healthcare services in relation to rural areas of Wales within a context of concomitant restructuring of rural society and restructuring and re-organisation of service delivery in the health sector which draws on 'theories of the firm' literature, for example the development of vertical integration of various primary healthcare services. A key element of primary healthcare service delivery in a rural context is related to the levels of accessibility to such services experienced by the individuals, or 'consumers' of healthcare. This thesis adopts a largely positivist approach to the analysis of spatial and temporal patterns of healthcare delivery in Wales over the last decade, although echoes of the structuralist approach emerge in relation to particular aspects of the analysis. In operationalising this theoretical context a Geographical Information Systems approach is employed to visualise and analyse the spatial organisation and temporal variation of primary healthcare delivery across rural Wales through a longitudinal study of primary healthcare services in Wales 1996 and 2004. Depth is added to this national level analysis of rural Wales by developing a case study of one Unitary Authority in rural Wales, Gwynedd, which acts as focus for more in-depth analysis of the spatial and temporal changes in rural primary healthcare over the study period