INTRODUCTION
The volume and complexity of what is done in general practice has increased inexorably over the last two decades. The UK population is larger, older, more diverse, and more likely to seek professional help for their health concerns. Care that used to be delivered by disease specialists in hospitals, particularly for long-term conditions, is now delivered by primary care teams in the community. Advances in technology offer prevention, cure, and palliation, which was unavailable in the past.
Successive UK governments should have recognised and planned for these trends but their response has been partial at best. In an effort to drive greater efficiency, policymakers have focused their attention on changing the structures and ways of working of the established model of general practice. This is resulting in larger scale organisations, a more diverse mix of primary care professionals, and greater use of technology to carry out tasks previously done by people. Some policymakers have pinned their hope on prevention and scientific innovations reducing future demand for health services.
DEMAND AND SUPPLY
While many of these changes are advantageous for other reasons, they fail to address …