Fix what's wrong, not what's right, with general practice in Britain

It has provided better health than government spending deserves

British primary care is said to be the envy of the world. The spirit of experimentation anchored to a sound foundation of care led by general practitioners provides other countries with examples of accessible services, continuity of care, and innovative payment systems. Although Britain's healthcare statistics are not the best in the world they are far better than expected given the comparatively low funding of the healthcare system and the relatively inadequate systems of social support. Seen from the outside, Britain has clearly done something right with its National Health Service, which is based on and increasingly strengthened by its infrastructure of primary care.

The key features of a strong, functioning primary healthcare system are the ability to provide continuity of care and a comprehensive financing system. Until now continuity of care has existed in the United Kingdom because every patient is registered with a general practitioner (a patient list system). People thus have the possibility of developing a long lasting relationship with a general practitioner of their choice, increasing the likelihood of satisfaction among patients.1 A relationship based on personal doctoring has multiple …