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The Contribution of General Practice and the General Practitioner to NHS Patients

The English Department of Health is currently shining the spotlight of health service reform on primary care, particularly general practice, in the form of a white paper on Health outside Hospitals. In essence the Department is heralding the introduction of competition into general practice, especially in under doctored areas, with the aim of offering patients a choice of practice and to introduce market forces into general practice provision.1,2 This follows hard on the heels of a completely new contract for general practice, introduced in April 2004, which probably represents the most ambitious pay for performance contract seen in health care anywhere in the world.3 Given this background, the authors use this article to reappraise the current evidence regarding general practice within the UK National Health Service (NHS), reflecting on its contribution, inherent advantages and shortcomings.