The Development of Primary Care

Abstract

Primary care has occupied a pivotal role in the NHS since 1948 with GPs acting as the first contact for over 90 per cent of users of NHS services, and acting as gate-keepers to the majority of other services. At the same time primary care has arguably been at the margin of the organisation, through a combination of the zealously preserved independent contractor status of GPs and the management of community health services by local authorities until 1974. Even after the integration of community health services into the NHS in 1974, family health services remained quite separately managed, although from 1974 until 1982 family practitioner committees (FPCs) were formally committees of the Area Health Authorities. From 1982 until 1990, family practitioner committees reported directly to the Department of Health (DoH).