Editorials

The nature of general practice

Patients and doctors are actors in a play written by history, directed by culture, and produced by politics. Over recent years, the producer has become increasingly autocratic, ignoring the experience of the writer, the sensitivity of the director, and the expertise of the actors. This has happened in many countries¹ but perhaps most obviously in the setting of British general practice.² The almost simultaneous introduction of a market ideology into the NHS and the imposition in 1990 of the new contract for general practice have been experienced as threats to the very nature of the discipline.^{3 4} General practitioners have felt bewildered and undervalued and there has been a worrying fall in applications for both vocational training schemes and practice vacancies. Government, policy makers, and managers are perceived as valuing the internationally recognised cost effectiveness of British general practice . . . [Full text of this article]

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