Abstract
In anticipation of the government's review of the National Health Service an inner city doctor considers some of the issues raised by a contract which will challenge the general practitioner to manage a budget for both primary and secondary care and will require standards of care to be audited. There will be difficult clinical, management and ethical problems ahead, but these are capable of being solved. Such a contract holds out the prospect of enhanced health care for patients and a more fulfilled professional life for general practitioners.
