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Practice Matters: the Early Years of Modern General Practice within the NHS

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It has been shown time and time again that nothing is more popular with the UK population than its National Health Service, yet it always seems to be a service in crisis. However, this unique book is a good news story about the service, and in particular, about its core - its 7 000 general practices.

Between 1974 and 2006 UK general practice underwent an astonishing evolution, moving from the baggage train of the NHS to become its vital, influential spearhead. The book explains how and why these changes came about. It is the first such account written by a GP whose career spanned that time, and who writes in detail of his own experience of those dramatic advances.

Laced with anecdotes that range from the farcically funny to profoundly sad, the book is part personal memoir, part an outline of the service’s historical background, and part a description of change: of political intrigue, innovations in buildings, staff and technology, and of the pioneering, individual initiatives that led to the development of modern general practice.

It traces the history of the author’s own practice from the days of Florence Nightingale (one of the practice’s doctors worked in Scutari hospital with her during the Crimean War) through the beginnings of the NHS, and its development until 2006. Between 1974-2006 were the crucial years of transformation for UK general practice, and here is an insider’s description from within a progressive practice.

In the 1970s the practice was amongst the pioneers of formal training for GPs and for employing practice nurses; it constructed two avant-garde buildings and in the 1990s took part in cutting-edge, national computer and technology projects for the NHS.

It was also involved at a local and national level in finding ways for all GPs to help develop their local services in ways that adhered to the core principles of the NHS, even when those ideas were at odds with the government’s preference for GP fundholding. Though highly controversial at the time, now - two decades later - much of the DNA of those projects can be found in current Clinical Commissioning Groups.

The various subjects of the book combine to offer a broad picture of those transformative years, explaining just how general practice has become so important and influential within the NHS. But it also goes on, to draw conclusions from those experiences and to offer ideas about how the service could be developed to make the best use of the resources available to it.

Those that value the NHS, and want it to prosper, need to know more about it in order to argue for its preservation and development. This book will help that process. And those outside the NHS, whether in the UK or abroad, that take an interest in the past, present and future of the service will also find this book of interest.




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