A healthier future: How to make general practice work better for everyone

This is a collection of essays about general practice in England and its future. The authors offer analysis and prescriptions based on expertise developed working in fields including medicine, NHS management, economics and the Civil Service.

The collection arose from responses to a newspaper article written by the SMF Director James Kirkup in August 2021.  They are reproduced here, with James’ thoughts on the essays and the issue.

The authors and their essays:

  • John Gooderham, a former senior civil servant, makes the case for a new mechanism to direct more GPs to work in the deprived areas where they are most needed.
    • Why we must amend the Health and Care Bill and establish an Office for Equitable Distribution of GPs in England 

  • Doug Russell, a doctor and former medical director, says the country must train more GPs, support them better and give them financial and professional reasons to choose to work in deprived areas.
    • Troubling patterns of overworking but underserving in the GP service, and what to do about it

  • Tim Howard, a retired GP, argues for surgeries to become fully-fledged wellbeing hubs – and argues that GPs cannot be expected to offer medical solutions to social problems.
    • GPs should work more closely with other services – and not be asked to solve wider social problems

  • Richard Disney, an economist, analyses the economic incentives offered to GPs over where and how to work, and uses economic theory to propose improvements.
    • GPs are economic agents, too

  • Simon Hodes, a working GP, summarises the pressures on practices and the day-to-day reality of a family doctor’s work.
    • There for us from cradle to grave, but have we ever considered what the GPs needs are?

  • John Allingham, a retired GP, suggests that the public should be taught to reduce unjustified demands on doctors’ time.
    • How freeing GPs from bureaucracy and low-level tasks can improve primary care

  • Dean Eggitt, a working GP, sets out a manifesto for sweeping change in primary care, including a new role for the private sector.
    • Each facet of the GP service is in dire need of reforms, for it to deliver care to UK’s ageing population



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