Synopsis
The UK National Health Service is always in crisis, yet it has been shown, time and time again, that the public value it more highly than anything else in British society. This book is a good news story about the service, and in particular, about its core - its 7 000 general practices. Between 1974 and 2006 UK general practice underwent an astonishing evolution, moving from the baggage train of the NHS to become its vital, influential spearhead. The book explains how and why these changes came about. It is the first such account written by a GP whose career spanned that time, and who writes in detail of his own experience of those dramatic advances. Laced with anecdotes that range from the farcically funny to profoundly sad, the book is part personal memoir, part an outline of the service’s history, and part a description of change: of political intrigue, innovations in buildings, staff and technology, and of the pioneering, individual initiatives that led to the development of modern general practice. As an example of the way practices have developed, the author traces the history of his own practice. He starts in the days of the Crimean War, when one of the practice’s doctors worked in Scutari hospital with Florence Nightingale. He then moves through the reasons why the NHS was established in the middle of the twentieth century, and on through its development until 2006. But the remarkable transformation of general practice took place between 1974-2006, and here is an insider’s description from within a progressive practice during those years. It includes the early days of formal training schemes for GPs, the employment of practice nurses, the construction of avant-garde buildings, and of cutting-edge, national computer and technology projects for the NHS. The book also describes the way some practices worked together in the 1990s to develop local services whilst adhering to the core principles of the NHS. Those ideas were at odds with the government’s preference for GP fundholding, and the book describes the difficulties behind their implementation. Though highly controversial at the time, much of the DNA of those projects can be found in current Clinical Commissioning Groups. The various parts of the book combine to offer a broad picture of just how general practice has become so important and influential within the NHS. But it also goes on, to draw conclusions from those experiences and to offer ideas about how the service could be developed to make the best use of the resources available to it. Anyone wanting the NHS to prosper, whether they work within it or use it as a patient, need to know more about it in order to argue for its preservation and development. Practice Matters will help that process. Whether in the UK or abroad, those that take an interest in the past, present and future of the NHS will find this unique book of interest.
About the Author
Before his retirement, Dr Andrew Willis was a general practitioner in the UK National Health Service. He was a partner in the same Northampton practice throughout his career. At different times, he also worked as a hospital clinical assistant in rheumatology, for 25 years as a visiting GP to an adolescent psychiatric unit, for Northampton Health Authority as its liaison GP – helping hospitals, GPs, health authorities and other agencies work together for the benefit of the community, and for Northamptonshire Family Health Services Authority as a consultant in general practice,. Conveniently, while his children were young, – he worked a weekly session as industrial doctor for the Mettoy toy factory. Following government reforms of the NHS in 1989, he was involved in planning local and national services, becoming chair of the National Association of Commissioning GPs in 1994, and then the first president of the NHS Alliance. His enthusiasm for developing general practice spanned its buildings, information systems, organisation, and personnel, and his practice made significant local and national contributions in all these fields. In 1991, he was awarded a Master in Social Science degree from Birmingham University for his work on the information needs of general practices, and the following year he achieved Fellowship by Assessment of the Royal College of General Practitioners. In retirement, much of his spare time is still consumed by designing and making things, whether in photography, gardening, or his primary enthusiasm for woodwork. His wife Eunice is also a retired GP; they moved to Chester in 2014. They have three children and seven grandchildren.
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