The chapter offers an overview of the health system in Hong Kong, identifying the priority health needs, pointing out the key system challenges in achieving a fit-for-purpose health system and explaining how to apply strategic purchasing in the primary healthcare setting. The chapter first introduces the concept of a “fit-for-purpose” health system and highlights the importance of primary healthcare development. It then discusses the challenges of the hospital and treatment-centric health system and identifies the opportunities for the application of strategic purchasing. Consolidating insights from an extensive literature review, the chapter examines how Hong Kong can leverage strategic purchasing to improve primary healthcare access, quality, and efficiency. It also explains how to implement strategic purchasing in the primary healthcare setting and across different levels of the health system.