ABSTRACT
This chapter describes the challenges facing general practice, and proposes that some broad functions emerge – consumer-responsive care, care based on a relationship, ‘specialist’ care, and contributing to the corporate governance of primary care. The collegiate foundation of general practice – the partnership – is increasingly obliged to adhere to new legislation and good practice in arenas other than medicine. For general practitioners, the forces driving change have presented them with a range of challenges which are both powerful and threatening. Some would like a more equal partnership, whereas others feel comfortable with the paternalistic doctor of old. Although impersonal services suit some individuals at some times, in other situations patients want a relationship with their professional attendant. Given the apparent chaos of the National Health Service, complexity theory may provide a better model for understanding the changes or at least accepting them with greater equanimity.
