‘You don’t know what you’ve got till it’s gone’: UK primary care on the global stage

The last few weeks have been filled with despair at the lack of understanding of everyday pressures in UK general practice by NHS England and the media. Despite being responsible for delivering a world-leading vaccination programme, managing record consultation figures,¹ adapting to large-scale roll-out of remote consultations, and providing 90% of NHS consultations,² GPs are portrayed as work-shy, out-ofdate, non-specialist obstacles to accessing hospital care.

Ironically, despite our own government and NHS leadership failing to value general practice, international healthcare experts are eager to invest in and develop their own primary care infrastructure, aware of the population health benefits, cost-effectiveness, and greater societal benefits this provides. Research from Harvard Medical School shows that increasing US primary care physician numbers increases average community life expectancy significantly more than additional specialist physicians.³ Advocacy groups such as the Primary Care Development Corporation in New York, US, aim to invest in the national primary care infrastructure to address pervasive gaps in care and healthcare inequity that a non-universal healthcare system reveals. Similarly, China is currently investing in and rapidly expanding its primary care system, after a recent hospital-centric healthcare transformation is limited in its ability to provide comprehensive universal health care to its citizens.⁴

Other nations are aware of the substantial benefits that a high-functioning, well-resourced, and universal primary care system provides, and are actively pursuing strategies to strengthen or establish their primary care systems. It would be nice if our healthcare leaders saw the same.