Abstract
This issue of the Journal of Primary Health Care (JPHC) looks at the hybridisation tension between the goals of not-for-profit organisations and the expectation that they behave more like businesses. There is tension between the goals of a not-for-profit health service like Newtown Union Health Service (NUHS) and the requirements placed on the service by government. It is too simple to say it is a tension between providing high-quality, patient-centred care and running a viable business, or that business practices are necessarily in conflict with providing good patient care. I have worked at NUHS for the past 25 years and will illustrate my arguments from my experience there. The views expressed are mine alone and do not necessarily reflect those of NUHS.