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What Will Primary Care Look Like In England by 2015?

The forthcoming white paper on health and community services in England will radically affect all our futures; so the BMJ asked people with an interest in general practice to predict the future//.

Senior doctors at the Royal College of General Practitioners predict that general practices will be highly evolved strategic organizations collaborating with one another in a community network.

They envisage a strong and vibrant, patient-centered primary healthcare system of consistently high quality, which is safe and accountable. They urge policy makers to build on the strengths and values of general practice, and avoid policies that run the risk of fragmenting care.

For Peter Lapsley, Chief Executive of the Skin Care Campaign, 2015 sees control of NHS budgets returned to central government and targets for access to general practitioners abandoned. Meanwhile, patients would have internalized health promotion messages and regularly attend wellbeing centres, sparing doctors and nurses to spend more time with the sickest patients. The concept of "patients as partners in their own healthcare" would also become a reality.

GP Dougal Jeffries envisions a return of a system based on social values. Expenditure on weapons get diverted to the NHS by 2015, coordination and cooperation supersede market forces, and patients are dealt with quickly and appropriately.

For Hamish Meldrum, Chairman of the BMA's General Practitioners Committee, the future finds general practice under pressure.

Political interference would leave the largely female profession feeling undervalued. The nature of general practice will also change considerably, with larger practices offering a wider range of services and videophone consultations relieving the problems of access to some extent. The NHS would still be ostensibly free at the point of use, but patients have to pay for non-essential services including hotel charges in hospital.

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