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January 5, 1976

Primary Medical Care: The Cooperative Solution to the Volume Problem

Author Affiliations

From the Norton Medical Center, Stockton-on-Tees, Cleveland County, England. Dr Marsh was a visiting associate professor in the Department of Family Practice at the University of Iowa Medical School.

JAMA. 1976;235(1):45-48. doi:10.1001/jama.1976.03260270031023

THE BRITISH National Health Service, now over a quarter of a century old, was introduced against a hail of criticism by doctors on both sides of the Atlantic. The criticism from the American Medical Association has continued across the years, although distinguished American dissentients from this view are now being heard.1-3 Promulgated by all three major political parties in Great Britain and effectively introduced by the Labor Party in 1948, the Service was part of a welfare package offered to a nation whose earlier wartime struggles appeared to have produced little in immediate material benefit. In 1948, the backlash of a war lay heavily on the community and manifested itself in anxieties, depressions, psychosomatic illnesses, and marital breakdowns. Many people had conditions for which therapy had not been sought because of the medical stringencies of the war years; others had handicaps as a result of war injuries. In addition,