ABSTRACT
Throughout the chapter, I use the term ‘primary care’ to mean general practitioners (GPs) and those who generally work alongside them, including practice nurses, health visitors and district nurses.
Socially, culturally and politically, primary care is constructed as the principal ‘open space’ that is accessible to the entire population, 24 hours a day, regardless of their age or health status. For most people, including children and their families, it is one of the first places to take narratives of distress, whether these concern minor and transient physical symptoms or matters of multiple loss. For some people, it is the only such space, since other arenas such as mental health services or social services may be seen as too inaccessible or stigmatising, or may operate in ways that effectively exclude some of the most needy members of the population by virtue of ethnicity, language, mobility, domicile, and so on. On average, someone living in the United Kingdom will see their GP three or four times a year, the equivalent of nine or ten consultations per household, and an astonishing one million consultations per day done by GPs alone. Around 20 per cent of these consultations will be focused on children’s problems, but children are also likely to be present in a considerable number of adult consultations, for example when their mothers visit doctors.
