The beginning of the end

British general practice is part of the fabric of our society. It is effective, precious, and threatened. It is not only possible but likely that within a few years the central feature of general practice—personal continuing care—will exist only in nostalgic memories.

The price of this efficiency will be the death of real general practice

Absurd? Let me explain. To reach this unhappy conclusion you have only to look at some of the apparently separate strands of recent government thinking to be able to see the type of cloth that it is weaving.

Information for Health—the government document on an information strategy for the NHS in England—has an aim that every doctor should be able to access every patient's notes at any hour of the day or night. Technically, this must be a good thing. From the point of …