New incentives for general practitioners in London

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7016.1314 (Published 18 November 1995) Cite this as: BMJ 1995;311:1314
  1. John Hayward,
  2. Michael Modell Both authors are members of the Camden & Islington Primary Care Education Board
  1. Adviser in public health and primary care North Camden Division, Camden and Islington Health Authorities, London NW1 2LJ
  2. Professor of primary health care Department of Primary Care and Population Sciences, University College London Medical School and the Royal Free Hospital School of Medicine, London N19 5NF

    An opportunity that must not be wasted

    The London Initiative Zone, encompassing an area of about 16 km radius from Piccadilly Circus, was set up by the Department of Health in 1993 “to concentrate attention and resources on developing primary care in the inner city.”1 Since then there have been schemes to improve general practice premises and expand primary care teams and community health services. General practice is the focus for primary care in Britain; but contented, keen doctors are likely to provide better care than unhappy and frustrated ones, and the morale of general practitioners in Britain has been steadily deteriorating.2 The Royal College of General Practitioners and the BMA's General Medical Services Committee have established task groups to review professional recruitment and morale and recommend ways of improving them.3 4

    Low morale has many causes, including increasing workload and professional isolation, inappropriate administrative tasks, unrealistic patient expectations, and an uncertain future. In London as in other large cities, high costs, social deprivation, a high turnover of patients, and the impact of closing hospital beds all combine to increase stress, while vocational training often fails to equip doctors with skills necessary for inner city practice. Other important reasons for decreased job satisfaction and failure to recruit general practitioners include a lack of protected study time to keep up with the …

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