Issues: Primary care/community nursing

The commencement of the 21st century has brought about many changes in the economy which have shaped the global community. Worldwide, governments have taken economic rationalisation and austerity measures (Humphreys 2009; Oberlander 2011). Health, one of the highest spending public sectors of most westernised economies, has suffered budgetary restraints with bed closures, job losses, longer waiting lists and ever increasing costs to access health services, which has contributed to deteriorating health outcomes (Humphreys 2009). Health remains the target of governments who aim to downsize and cost shift (Giddings 2011; Oberlander 2011). In addition to the immediate implications of tight fiscal management of health care, there are peripheral effects caused by economic rationalisation. This has impacted the nursing and midwifery professions in various ways, in particular those that work in the primary care/community nursing sector.