None of this, however, comes free. Firstly, if the registered list is that important, then it is equally important that every patient should be able to register with a practice that meets minimum standards.
Secondly, if personal care and continuity matter, then every patient should be able to relate to a nominated GP if they wish. Most practices offer this, but some don't.
Thirdly, the market is never going to go away altogether. It is inevitable and provides an effective hedge against complacency. When we ask for some protection (excluding short-term contracts, sale of goodwill and the like) then the price is that we must keep to the moral high ground as family doctors, local leaders and commissioners.
If we seek to profiteer, either from our peers (by offering only salaried positions rather than partnerships) or from our patients (putting our businesses before them) then we can expect the full force of the open market.
General practice is now being offered more than ever before in my 25 years as a GP. It is capable of doing ever more. As innovative clinicians who know their patient population better than any, we have every right to be confident. Our lasting survival depends on being able to do the job better than anyone else. We should not be afraid to raise our game and welcome our new responsibilities along with our new power and accept the risks that are outweighed by the new opportunities. Good practices have nothing to fear.
But, if we allow ourselves to be seen as the bolshy brigade, we simply feed the monster that says that GPs are neither up for the job nor up to it.
Then we could, with justification, be thrown to the wolves of the uncontrolled market.
Dr Michael Dixon, chairman, NHS Alliance.