title: Primary care physicians' attitudes to health care reform in England.
abstract: Primary care organisation in England has been subject to particularly extensive and far-reaching reform in recent years. In 1991, a quasi-market was introduced into the National Health Service and general practitioners were offered the opportunity to manage independent budgets from which to purchase and deliver care services. Practitioners joined the scheme in increasing numbers, although it was eventually abandoned following a change of government in 1997. This paper reports the results of two surveys of primary care physicians' opinions on the English health care reforms, conducted in 1997 and 2000. It concludes that, first, those opting for discretionary budgets were significantly more supportive of the policy than those not joining the scheme and this support continued long after the scheme had been abolished. Second, professional attitudes, with respect to other terms of service in primary care, remained homogenous to a considerable degree over time. Finally, physicians in favour of imposing user charges tend to be those with responsibility for more patients, suggesting a perceived need to manage patient demand.
authors.affiliation: School of Economics, University of Nottingham, UK. david.whynes@nottingham.ac.uk
authors.forename: David K
authors.initials: DK
authors.lastname: Whynes
authors.forename: Darrin L
authors.initials: DL
authors.lastname: Baines
mesh_terms: D001291:Attitude of Health Personnel; D002017:Budgets; D004739:England; D005194:Family Practice / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D015276:Health Care Rationing; D018166:Health Care Reform / Q000331:legislation & jurisprudence*; D019538:Health Care Surveys; D006801:Humans; D009936:Organizational Innovation; D010821:Physicians, Family / Q000523:psychology*; D011320:Primary Health Care / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D013222:State Medicine / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D011795:Surveys and Questionnaires