Viewpoint: Who should be providing 'primary' care - GPs or patients?

Does primary mean first or initial? In either case, we are using the wrong word.

Over the past couple of weeks I have been working with GPs, discussing how they are developing their work in the light of the pressure coming from ever-increasing demand for care.

They are not alone in trying to encourage their registered population to better look after themselves and not to go to their GP with every aspect of their ill health. This is not a new expectation for primary care but it is one that is being addressed more and more systemically by a system under very heavy pressure.

Quite rightly, with a set of systems and experiences of ill health, the public are expected to find new ways to look after themselves without bothering the NHS at all. It’s correct that a combination of friends, families and the internet can help us turn around the smaller trials and tribulations of ill health.

What does 'primary care' mean?

But, reading through the above, if 'primary' as a word means anything it must mean a description of what is first or initial in the care that I look for when I am sick.

The fact that what we call primary care at the moment is labelled as such means that I am quite correct in seeing the initial care I want as coming from the GP. And most GPs would have it no other way - defining themselves against secondary care, they quite rightly see themselves as coming before the consultant.

So are we really encouraging the public to see the initial - the primary - care that they need as coming from themselves and their community? Are we really encouraging the use of good internet tools to self-diagnose, for example, the initial stages of a cough or a back ache caused by repetitive actions?

We need the public to see themselves, their communities and the internet, as the primary care system. The future of the health services depends upon the development of this primary care system to deal with a large part of the experience of ill health. And we need to think hard about the investment needed there.   

Or do we still see GPs as primary?

  • Paul Corrigan is a management consultant and former health adviser to Tony Blair. This article was first published on our commissioning website Inside Commissioning

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