General Practice to Primary Care

The Industrialization of Family Medicine

By: Steve Iliffe

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Paperback | 1 January 2008 | Edition Number 7

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248 Pages

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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 other professions 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.

Industry Reviews

Professor Illife has presented a view of what is happening to general practice that is both immensely simple and profoundly complex. The changes that have afflicted general practice in the UK in the last 20 years are all part of a single process: industrialisation...he pursues his case in compelling historical and theoretical detail...this makes the book a challenging read...a thorough, impressive, and persuasive book. London Journal of Primary Care

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