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Rise and fall

Correspondence to:
Dr John Launer, London Deanery, 85 Sutton Road, London N10 1HH, UK; jlauner@londondeanery.ac.uk

The first 150 words of the full text of this article appear below.

If you travel almost anywhere in the world and talk to family physicians, you will find that they regard the British system of general practice as an ideal. Some of its central principles—including continuity of personal care, and acting as a "gatekeeper" for all hospital referrals—are widely envied, and have provided a model for other primary care systems. Yet British general practice is now in serious trouble. General practitioners in Britain are locked into a dispute with the government, and the outcome may be ugly. On the surface the argument is about opening hours and money. Underneath, the issue is about professional autonomy and privatisation. This battle is only the most recent one in a war that has been going on for at least two decades. During that time, some of the features of general practice that were most admired, such as 24 h responsibility for patients, have already fallen . . . [Full text of this article]