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Jeremy Gibson writes about what future there is for general practice.1 I agree when he is in favour of a clear career structure with the opportunities and incentives to progress,2 but I wonder when he states that the days of the single-handed GPs are passing and that Darzi's centres loom.
He indicates that practices have to get bigger still, containing at least 30 fulltime salaried GPs, under the auspices of primary care trusts and that these larger organisations will give more room for GPs to grow professionally. There will be more opportunities to develop special interests, and incorporate more variety into their working week.
I wonder if this could be true. Firstly, have we asked patients what they really need, what they like, and are looking for in primary care? Literature is full of how much patients want a personal and counselling doctor, continuity of care, and a comfortable practice near home.
Also, what about all the international European Documents, such as the European Definition by WONCA and the EURACT Educational Agenda? In them, we defined, with European agreement, that a GP is a doctor with specific clinical skills and mainly, in this case, with a person-centred approach, with community orientation and, last but not least, with the unique and personal biopsycho-social holistic approach.3
How could all the core competences and specificities of general practice be applicable for patients in structures like the GP-led health centres for specialists?