Bill Harvey: Striking the right balance in primary care

As this issue goes to press, the main news is that junior doctors have gone on strike, downing tools in all areas for the first time since the NHS began. Despite some media slants suggesting otherwise, the dispute is ‘cash neutral’.

Rather, it is primarily a protest against a heavy-handed approach by current government to impose a contract change which, without any evidence to back up the statistically spurious but sound bite friendly adoption of 24/7 cover, has almost certain consequences on both doctor’s working conditions and, more importantly, quality of NHS care provision.

A country weary of pre-war privilege and class-ridden deference embraced notions such as income-linked national insurance schemes. These promised the delivery of care way beyond the door-to-door ‘how much can you afford?’ service remembered from the post-Victorian era.