Almost every day general practice, or practitioners, are somewhere in the news. Usually it’s not good news either. Strikes, vacancies, waiting lists: we are riddled with delays and fail to meet targets. But seldom do the mechanisms of the problems – especially the way we work and organise to work – reach the media. In the process of writing a book -The State of Medicine- I started to realise that bad organisation, poor quality NHS spending and non evidence based policy was nothing new. In fact, it was a repeated cycle. We had said goodbye to Dr Finlay but how were we deciding who was replacing him?
The history of general practice is long and precedes the NHS. The doctors and historians who contributed to the series have illuminated a history that makes sense of the present – why GPs have a tension with their contract, being usually contracted to the NHS rather than directly employed by it: why overwork and working days into nights was simply impossible to continue with increased demand. My hope is that by looking backwards we can learn enough to make more sense of how to go forwards.
There is one question I would love historians to tell me: when was the first recorded use of the term ‘general practitioner’? Irvine Louden says 1809, but @mc_hankins tweeted a reference to a job advert in the Times for ‘a gentleman, properly qualified, and wishing to settle in London, as a general practitioner in one of the three departments of the profession’…I hope they had some respondents.
Dr Margaret McCartney is a general practitioner in Glasgow and BMJ columnist who presented the recent BBC Radio 4 programme Farewell Dr Finlay; a history of general practice. ‘