Primary care: restoring the jewel in the crownBMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7047.1624 (Published 29 June 1996) Cite this as: BMJ 1996;312:1624
- Ian Bogle,
- John Chisholm
- Chairman Joint deputy chairman General Medical Services Committee, British Medical Association, BMA House, London WC1H 9JP
Britain's government is at last listening to general practitioners' concerns
From the mid-eighties onwards, a succession of government documents1 2 3 and policy decisions heralded a radical transformation of British general practice. The new contract was imposed in April 19904 and the NHS reforms were implemented a year later. The secretary of state for health, Stephen Dorrell, speaking in January, described the last few years as “a period of bruising management change,” in which “huge amounts of time and effort have been consumed in reorganising the management of the service.”5
This agenda of constant change and policies imposed on an unwilling profession have caused a sense of powerlessness, loss of independence, and demoralisation, which have contributed to increasing numbers of early retirements and a recruitment crisis in general practice.6 By its actions, the government showed that it no longer valued its partnership with the profession.
However, the sense of alienation felt by general practitioners has been slowly assuaged over the past six years, and such recent developments as the changed arrangements for out of hours care,7 for complaints,8 9 and for health promotion10 have shown both a …