Keep primary health care personal!

In the fifties and sixties a rebirth for primary health care (PHC) took place in the United Kingdom and The Netherlands. New scientific journals started: the Journal of the College of GP's (now the British Journal of General Practice) in the UK and Huisarts en Wetenschap in The Netherlands. In 1966 in both countries reforms took place to reinforce General Practitioners within the health care system. In Holland, 1966 was the start for the development of the world famous GP-standards and for many multidisciplinary health care centres. Also in that year, the first Dutch chair in general practice was inaugurated [1]. In the UK Richard Scott had been appointed to the first GP chair in the world in Edinburgh in 1963. In 1966, after bitter negotiations, the government and the GP political leaders agreed the so-called GP charter. This notably rewarded GPs for improving their practices (previously this had been at their own personal expense), it also included incentives for GPs to practice together in groups and to undertake postgraduate education. A second key UK landmark was the nationwide introduction of three years compulsory vocational training for GPs in 1979. By the eighties Fry was able to [2] publish five common features of PHC: (1) Access and availability on a round-the-clock basis. (2) First contact assessment and ongoing management of complaints, demanding an intimate understanding of both the patients and their problems. (3) Care provision to a relatively small, static population of around 2,000 individuals. (4) The type and nature of illnesses and conditions seen in primary care practice reflects the specific needs of each patient population. (5) Long-term continuity of care is possible. Since the sixties, in European and North American countries PHC became a success story. The United Kingdom, Finland, Denmark, The Netherlands created strong PHC systems with family doctors at the core of it. Since 1980, in the United States the Health Maintenance Organisations were growing at a fast speed. In the centre of the HMOs the primary care physicians play the key role. Nowadays, more than 50% of the Americans are insured through an HMO system. In Canada, General Practitioners are at the centre of the system. Recently, Germany and France decided to adopt some features of the PHC system from their neighbouring countries. Important principles for a strong PHC system were and are: (1) Listing of patients, which means that patients have to sign up …