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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 October 13; 335(7623): 735.
PMCID: PMC2018795
The Primary Care Market

More questions than answers

Hendrik J Beerstecher, general practitioner principal

Pollock et al ask “how will National Health Service spending be accounted for in the new primary care market?”1

When I asked to see the financial details of the contracts with private providers the reply was, “I can confirm that the department holds details of the cost of the Walk in Centre and general medical services, however it is not currently prepared to release this information.”

With all the talk of competition, some questions remain. Why are personal medical services, alternative medical provider services, and private contractors not offered the same capitations as general medical service contractors, determined by an allocation formula that takes account of patients' needs?2 Why did the advisory board for alternative medical provider contracts contain several of the private companies that are now providing primary care services?3

A final detail, the Barking and Dagenham surgery and walk-in centre (that reputedly received £5m (€7m; $10m) for a five year contract) is not catering for 7000 patients yet—that is the number of patients who will potentially be registered at the end of the five year period.4 How many patients are registered for primary care services and at what cost is known by the Department of Health only for the time being.


Competing interests: None declared.


1. Pollock AM, Price D, Viebrock E, Miller E, Watt G. The market in primary care. BMJ 2007;335:475-7. (8 September.) [PMC free article] [PubMed]
2. Morgan CL, Beerstecher HJ. Primary care funding, contract status, and outcomes. An observational study. Br J Gen Pract 2006;56:825-9. [PMC free article] [PubMed]
3. The NHS confederation. APMS core group meeting. 21 July 2004, London.
4. Day M. UK government accused of privatising the NHS. BMJ 2006;333:61 doi: 10.1136/bmj.333.7558.61

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