ABSTRACT

Revolutionary leaders who have championed ‘the common man’ have all too often discovered to their discomfort that such an individual, if he exists, does so in his, or just as likely her, own right, with clear views on the subject of self-interest. The parallel is the so-called ‘consumer’ of the contemporary National Health Service (NHS). External influences already are and will continue to be far reaching in their influence: on procurement procedures, health and safety standards, capital investment, drugs misuse prevention programmes and many other areas. In November 1996 at their Annual Course in Glasgow, the 150 members of the Association of Managers in General Practice present were more concerned with looking at ten alternative future techniques for constraining demand in primary care. A primary care-led NHS had as its policy sub-agenda priority setting for secondary care. The policy of creating a more primary care-centred health system in the UK needs to be understood in the context.