General practice at the heart of the NHS: now and in the future

摘要

The NHS is 70 this year. It is often said that our National Health Service is the closest thing we have in the UK to a national religion; be that as it may, it is clearly treasured by the British public, and respected worldwide.The role of general practice in the NHS at the beginning was rocky to say the least, but over the years, our profession has flourished, due in no small part to the remarkable efforts of hard-working, visionary GPs over the decades. Indeed, Simon Stevens, Chief Executive of NHS England, has said that there is arguably no more important job in modern Britain than that of the family doctor.1Today, it is widely accepted that a robust general practice service is the bedrock of any functional, cost-effective, and sustainable health service — and ours is ranked by many as being the best in the world.2In my view, one of the greatest achievements of the NHS over the past 70 years has been the GP–patient consultation:3 that precious time in which GPs build trust and connect with our patients, and during which we manage a great deal of risk, thereby keeping the vast majority of patients safe, while using our NHS resources most efficiently.However, there are many more achievements for which general practice can take credit. Dr Julian Tudor Hart’s Inverse Care Law, published in 1971,4 articulated the challenge of health inequalities that still resonate today; robust, applied medical research with its foundation in general practice, as demonstrated by the Royal College of General Practictioner’s …