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Br J Gen Pract. 2007 December 1; 57(545): 995.
PMCID: PMC2084143

Dismantling general practice

‘Dismantling general practice’ was a sobering paper, indeed.1 I note that Roger Jones' earliest reference is dated 1974. This process was initiated long before this, with the instigation of merit awards for a proportion of consultants, the purchase and sale of goodwill in general practice being made illegal and case notes becoming the property of the Minister of Health — at the very outset of the NHS.

So what kind of jewel are we talking about? The fantasy of the jewel came much later — perhaps it would be charitable to suggest that Bevan was confused by carats and carrots? He certainly rejoiced in his successful use of the latter when devising merit awards, claiming publicly that he has ‘… stuffed their mouths with gold.’ — his words, not mine. And he was greatly encouraged by the words of a distinguished physician who told him that the GP was ‘… the doctor who had fallen off the ladder of success.’ To complement the carrot, of course, he used the stick on GPs in effectively confiscating their hard-earned (or dearly-borrowed) investment.

Added to this disgraceful employment of bribery and blackmail, by destroying the privacy of case notes he ensured the ultimate demise of the very core of top-class general practice — the trust underlying the precious doctor-patient relationship.

I do not very much care for having become a patient. But worse is having to pay more and more tax to fund this sorry dismantling.


1. Jones R. Dismantling general practice. Br J Gen Pract. 2007;57(544):860–861. [PMC free article] [PubMed]

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