From General Practice to Primary Care: The Industrialization of Family Medicine

Citation

(2008), "From General Practice to Primary Care: The Industrialization of Family Medicine", International Journal of Health Care Quality Assurance, Vol. 21 No. 5. https://doi.org/10.1108/ijhcqa.2008.06221eae.002

From General Practice to Primary Care: The Industrialization of Family Medicine

Article Type: Recent publications From: International Journal of Health Care Quality Assurance, Volume 21, Issue 5

Steve Iliffe,Oxford University Press,2008,ISBN-13: 978-0-19-921450-1,

Keywords: Gatekeeper role, Governance, Quality frameworks, Continuity of care

A controversial book that offers a critique of some decisions in the health service. Contains a historical perspective on recent changes to the UK NHS and draws on sociological, economic, political and psychological sources to tell its story. Although focused around changes in the UK NHS, the themes have relevance for countries with a similar gatekeeper role, and where primary care is under threat.

Anxiety about medicine becoming impersonal and mechanised permeates the NHS. In addition, the popular media is full of stories about the health service and its unhappy staff, focusing on the belief that professionals and patients are being turned into assembly-line workers and objects. This is particularly prevalent in general practice, as plans for massive policlinics are revealed and payment systems shift seemingly inexorably towards incentives and targets. The ethos of family medicine, which places so much stress on continuity of care, psychosocial understanding of illness, and the careful management of doubt, is challenged by guidelines, governance, quality frameworks, and patient satisfaction surveys. General practice is being industrialized into primary care, or so it can seem.

This book explores the many dimensions of industrialization as it has occurred to others in the past, and analyses the origins of the current wave of reform in general practice. It analyses why industrialization is being pursued as a government strategy, and explores its benefits and dangers. It concludes that the medical profession has reasons for being perturbed by industrialization, but that it has advantages as well as disadvantages for the NHS and the public. Its conclusions may not please either policy makers or practitioners, but they offer ways for professionals working in the community to customise current changes in potentially beneficial ways.

Readership: This book will appeal to trainees and qualified professionals in both general practice and public health, to understand the changes that are underway in the NHS. Practice nurses and anyone involved in health policy/NHS management, health and social care, and health promotion will also relate to the themes in this book. It will also be invaluable to those teaching in any of these areas.

Contents include:

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  Industrialization.

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  Management.

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  Forward integration.

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  Mass production.

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  Evidence based medicine.

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  Clinical governance.

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  Consumerism and producerism.

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  What are the alternatives?