ABSTRACT
The comprehensive system of primary medical care, which underpins service equality and access, is the most enduring and unique characteristic of the National Health Service (NHS). The contractual relationship between general practitioners and the government allows the doctors to be self-employed and/or in partnership and to receive payment from the Department of Health in exchange for an agreed set of services and commitments. Since 1990, many reforms have been imposed upon the NHS and primary medical care in particular. The fundholding initiative was regarded as the jewel in the crown of the government's highly unpopular reform programme. The Labour party has had a yearning for a salaried service in primary care with potentially the direction of labour in pursuit of greater equality of access to health services. In the event of a long spell of Labour government, a gradual return to traditional values is likely as political and public confidence grows.
