Even in OECD countries regarded as having strong primary care, such as the United Kingdom, Australia and New Zealand, a large proportion of doctors continue to work as solo-practitioners. The average primary care clinic in Israel is staffed by the equivalent of 3.4 general practitioners, 2.6 nurses, 1.5 practice assistants and most have a practice manager. In recent years, the United Kingdom, Australia, France and Switzerland have changed financing or provided additional payments to general practitioners to try and prioritise such services and had limited success in driving system-wide change.