ABSTRACT
The case for focusing on general practice in our chapter in the first edition of this volume nearly twenty years ago (Calnan and Gabe 1991) was that it was seen to hold a key position in the provision of health care in the UK National Health Service (NHS), mainly through its dual role as co-ordinator of patient care and gatekeeper and controller of access to specialist services, high technological care and treatment. Since then the importance of primary care in the NHS in England has, in many respects, been enhanced, although the structure and organization of general practice, as will be shown below, has altered. The aim of this chapter is to examine changes that have taken place in primary care over the last twenty-five years and to provide a sociological account of these developments. The focus once again is general practice although it is recognized that there are other primary care services such as dentistry (Calnan et al. 2000), opthalmology (Green and Thorogood 1998) and community pharmacy (Edmonds and Calnan 2001) which are not discussed here but have also undergone change.
