TY - JOUR T1 - The Family Doctor Charter: 50 years on JF - British Journal of General Practice JO - Br J Gen Pract SP - 227 LP - 228 DO - 10.3399/bjgp17X690809 VL - 67 IS - 658 AU - Stephen Gillam Y1 - 2017/05/01 UR - http://bjgp.org/content/67/658/227.abstract N2 - Among innumerable white papers and contractual revisions, three legislative milestones bestride the organisational development of British general practice in the second half of the 20th century. Two of these events form ‘book-ends’ to the third. First, the NHS Act of 1947 cemented the place of general practice in the new health system. Second, the Family Doctor Charter, enacted in 1966, revitalised the discipline after a period of stagnation and ushered in a ‘golden age’ of general practice. The expansionism of this era extended its range of responsibilities in various ways. To these were added a purchasing function following the Working for Patients white paper of 1989. The consequences of this third milestone are still being worked through. Why was the Charter required, what did it portend, and how should we look back on it half a century on?Rose-tinted historiography in support of Beveridge’s vision has obscured shortcomings in the NHS.1 In reality, general medical care was reorganised but not transformed. For GPs, the NHS represented an elaboration of the system of National Health Insurance (NHI) established in 1911, under which a capitation system also operated. Many of the regulations of the NHI scheme were simply transferred into the NHS. These were compiled in that industrial artefact of hallowed memory, the ‘Red Book’. The major change was to extend health care free at the point of delivery from insured working class males to the whole population. However, there were limited economic incentives to provide good patient care; rather, they kept lists long and costs low. The standards and social ethos of care were largely a continuation of the old panel system.2Workloads … ER -