A US model for primary care in the NHS

BMJ 2005; 330 doi: (Published 03 March 2005) Cite this as: BMJ 2005;330:547
  1. Linda Hill, clinical professor (
  1. Department of family and preventive medicine, University of California, San Diego

    In July 2001 I began a year working in a primary care trust in east London. My career had already taken me from Canada, where I trained, to the United States, where I worked for 20 years in a community health clinic. There we served a medically indigent population, including refugees and new immigrants of Asian, African, and Latin and South American origin. In going to England I was eager to return to a country with socialised medicine and to compare the NHS's ability to provide care for a community with a similar low socioeconomic profile. To this end I became the lead person for cardiovascular health promotion in Tower Hamlets for a year.

    Our centre in San Diego, one of 10 000 non-profit, community based health centres across the country, provides care for adults and children, comprehensive family planning, gynaecological services (including colposcopy), …

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