As has been seen, before the NHS, many families relied on the casualty department to obtain primary care. Although following the 1911 National Insurance Act, workers could obtain free care from their general practitioner, this was not extended to their families. With the start of the NHS, it was expected that hospitals would cease to provide primary care, as all patients would be able to obtain free treatment from their general practitioner. Clarkson reported that at Guy’s Hospital there was a 20 per cent reduction in the numbers of sick attending and a 60 per cent fall in the number of children1 following the introduction of the NHS. However the NHS system of capitation payments offered the GP no incentives for discouraging patients from attending A&E and a GP has written: ‘Instead GPs became increasingly concerned that any shift of demand away from A&E would lead to increased GP workload without parallel increases in resources.’2


Primary Care Primary Care Patient Primary Care Centre Emergency Centre Triage Nurse 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Henry Guly 2005

Authors and Affiliations

  • Henry Guly
    • 1
  1. 1.Derriford HospitalPlymouthUK

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