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Purchasing patient-centred health (and social) care requires deliberate focus on the patient through: patient centred care planning in the primary care setting; close collaboration between purchasers, general practitioners and the primary health care team; integrated health care provision; detailed case mix outcome measures. Eight possible ways are suggested for analysing service requirements in order to develop effective purchasing plans. Of these: population `need', and care processes are recommended as basic building blocks in combination with: location of care, and outcomes at each location. A fundamental change is required of purchasers and providers who must recognise the importance of the general practitioner role in care planning, making that role explicit and support its development. 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