There is a wide perception that British general practice is being compromised.1 As it has been ‘the envy of most of the western world’,2 this is of concern. The new General Medical Services (GMS) contract offers and emphasises supplemental reimbursements that are limited to the provision of measurable clinical services. Are NHS quality efforts aiming to improving care consistent with its commitment to a ‘primary care centred’ health service? To answer this question, we draw on evidence of the benefits of a primary care-led health system, explore aspects of primary care responsible for its benefits, and discuss how current efforts in the US and the UK threaten the achievements of primary care.
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