TY - JOUR T1 - What sort of practice in 2040? JF - British Journal of General Practice JO - Br J Gen Pract SP - 556 LP - 557 DO - 10.3399/bjgp18X699857 VL - 68 IS - 677 AU - Roger Jones Y1 - 2018/12/01 UR - http://bjgp.org/content/68/677/556.abstract N2 - It would be foolish to predict the shape of health care in 20 years’ time, but a greater folly not to ask what sort of health system we would like to see, thereby shaping the future and facing up to some difficult questions along the way. We can no longer rely on short-term fixes and the tides of party politics. If major surgery is needed, cosmetic adjustments will not do. We need to envision a system of healthcare firmly founded on the values of equity, inclusion, social justice, and compassion. Graham Watt’s powerful accompanying editorial on the shameful persistence of Julian Tudor Hart’s inverse care law pulls no punches on this, and warns of a potential nightmare scenario — ‘the social horror of market forces determining the future of the NHS’.The NHS is still capable of delivering superb care. There is excellent general practice and marvellous hospital care. Thousands of hard-working, resourceful, and committed people are still prepared to go the extra mile. However there are deep systemic problems. Quality is uneven, funding inadequate, recruitment and retention rates dangerously low, morale in some sectors is in tatters, and, on a number of metrics, patient outcomes and health indicators fall below those of our European neighbours. The status quo is not an option and there is danger in regarding recent funding commitments made by the Prime Minister as the solution to a problem which requires radical, structural reform. Any new vision of health care must command the support of doctors, nurses and other health professionals, patients, politicians, and funding agencies, and describe a future in which the medical and clinical workforce has reclaimed its morale and professional pride. It must be realistic and achievable, and will need to capture the imagination of medical professionals across the workforce and at all … ER -