Patient co-payments for general practice.

good for patients and a tool for promoting practice federation, the key to modernising primary care. Combining this with a clamp on primary care funding appears illogical but ensures that more and more partners will be replaced by assistants until partnerships become neither viable nor identifiable. When partners themselves demand a salaried service, no doubt to be managed by private healthcare providers, they will be surprised that the money on offer will be based on the average salary of an assistant, not that of a partner. In the interests of self-preservation, they will have extracted all the gold from the ‘golden era’. The small business model may seem to serve a dwindling elite of general practice partners but no longer serves the interests of patients or today’s young doctors. It should be abandoned while our leaders are still in a position to negotiate terms.