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The Medical Profession and the State: GPs and the GP Contract in the 1960s and the 1990s
Author(s) -
Lewis Jane
Publication year - 1998
Publication title -
social policy and administration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.972
H-Index - 63
eISSN - 1467-9515
pISSN - 0144-5596
DOI - 10.1111/1467-9515.00093
Subject(s) - global positioning system , autonomy , government (linguistics) , state (computer science) , public administration , accountability , business , public relations , political science , law , engineering , computer science , telecommunications , linguistics , philosophy , algorithm
This paper examines the two major conflicts between general practitioners and the state in the mid‐1960s and again at the end of the 1980s. In the mid‐1960s morale in general practice was low, but GPs emerged with a strong endorsement from government for their professional autonomy. In 1990 morale was high, but government succeeded in imposing a new contract on GPs that sought to increase their accountability. GPs have always defended their status as "independent contractors". However, the paper argues that GPs saw this status as a means of protecting their professional freedom and autonomy. When the government treated them more as independent contractors in 1990 and demanded more specific terms, GPs did not like it. Furthermore, the new GPs’ contract was introduced alongside the new internal market of the NHS, which has had further implications for GPs’ status as independent contractors.