Steve Iliffe

Anxiety about medicine becoming impersonal and mechanised permeates the NHS. 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, qualityframeworks, and patient satisfaction surveys. General practice is being industrialized into primary care, or so it can seem. This book explores the origins of industrialization, why it is being implemented by government policy, and what it offers both patients and staff. Are thereboth benefits and disadvantages? Finally, how should those working in the community work with the changes to offer the best possible quality of health care?

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