As your editorial on Labour’s plan for the NHS points out (23 May), health is largely determined by political choices. To restore the NHS, we could learn from its history. The independent contractor model of primary care has been an NHS success story and, arguably, its collapse is at the root of the service’s wider malaise.
Unifying fragmented primary, community and social care staff in independent, wholly subcontracted organisations under one roof, possibly as social enterprises or John Lewis-style partnerships, would improve care, lift staff morale and release funds to address the workforce crisis. Relocating services currently provided in hospitals – such as urgent care, diagnostics and outpatients – into the community would offer the opportunity for care to be delivered using the personalised, relationship-based and cost-effective model traditionally used by family doctors.
