Abstract
May I add to the interesting paper by Dr Azeem Majeed on British general practice? 1 The attitude of general practitioners towards their patients and their style of practice depends partly on how you pay them. There are three possibilities: salary; fee per item of service; and capitation. Each has advantages and disadvantages. 2 The least desirable is the British method of capitation which serves to empower the doctor at the expense of the patient. If British general practitioners were switched to ‘fee per item of service’, attitudes would change overnight. Notices would vanish from waiting room walls, prompt appointments would become available and home visiting would be resumed. There is a lot to be said for a ‘Tesco’ NHS. 3