Competition in general practice

doi:10.1136/bmj.331.7526.1196

BMJ 2005;331:1196-1199 (19 November), doi:10.1136/bmj.331.7526.1196

Education and debate

The NHS revolution: health care in the market place

Competition in general practice

Martin Marshall, professor of general practice¹, Tim Wilson, general practitioner²

¹ National Primary Care Research and Development Centre, University of Manchester, Manchester M13 9PL, ² Mill Stream Surgery, Benson, Oxfordshire OX10 6RL

Correspondence to: M Marshall martin.marshall@manchester.ac.uk

UK general practitioners seem likely to face competition fortheir services. Can the market place improve on the weaknessesof primary care without affecting its strengths?

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

Introduction

General practice is bracing itself. After more than seven yearsof reform in the United Kingdom's acute sector, the politicalspotlight is now falling on primary care. A new contract wasintroduced in 2004 linking up to 20% of a practice's incometo specified activities,¹ and further reform is on its way.General practice might be regarded by international observersas the jewel in the crown of the British health system,² butsome policy makers are suggesting that it needs to be shakenup if it is to play its part in delivering a high quality, patientcentred NHS. The government looks set to introduce some sortof competition into the primary care market. We explore thepurpose of such a policy and its implications for patient care.

Walk-in centres suit patients who value accessibility over continuity of care

Credit: MICHAEL DONNE/SPL

General practice reforms

Much of the discussion about the future of . . . [Full text of this article]

Current structure of general practice

Strengths and weaknesses of the established model

Other market based models

Conclusions

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