What's Wrong with General Practice?
What's wrong with general practice? Lots, apparently. All too often the media treats it as if this branch of the NHS is still locked in the 1950s. Poor services; poor knowledge; simply an acute care service, the main value of which was a rather iffy referral system that protected hospitals.
Is this the paranoia of a blinkered, self pitying GP? Nope - not at all. I was indeed a GP, but I retired over a decade ago. Since then my only contact with the NHS has been as a patient, attending my local practice as one of its thousands of registered patients for annual flu vaccinations, and for the periodic review of my ongoing hypertension and its medication. And, once, I went because I had strained my back gardening.
And there lies the point, the fundamental value of general practice. It is unique in -
combining care for a defined list of patients,
offering a comprehensive range of preventive care from before birth to the end of life,
providing the unconditional management of long term conditions,
and unlimited acute care of short term conditions.
No other branch of the service even attempts to do that, and collectively they cover almost the entire population of the UK.
General Practice is far from perfect; in places it is down right poor, but despite being harnessed with that astonishing range of responsibilities it is - in the main - remarkably good. It is certainly light years away from its state in the 1950s, and without it the NHS would sink beneath the waves within weeks. Against popular perception, it is the jewel in the crown of healthcare in this country.
But little has been written about it. In fact, as far as I can tell, my book Practice Matters: the Early Years of Modern General Practice within the NHS was the first book to be written on the development of modern general practice. That is a tragedy, for general practice has so much to be proud of, and its contribution to the NHS - and the health care of the population of the UK - is immense.
To emphasise the extent of that change in general practice I am offering a free download of the Introduction and first chapter of my book here.
There are absolutely no strings attached - I do not even require the usual email address that tends to go with such offers. Just have a read, and download it if you want. I hope you enjoy it and perhaps learn something useful.
General practice deserves a better understanding, and its centrality to the future success of the NHS needs throwing up in flashing lights.