Work patterns in UK general practice: turning the clock back?

have traded a bit of autonomy for the greater good when clinical freedom is now so difficult to defend; or that general practice mainly provides Monday to Friday daytime care in the NHS and many other healthcare systems. The research on the dangers of stress and poor morale has convinced doctors, and more importantly their negotiators, that quality of life needs to be taken more seriously. What happens in the NHS is important internationally as even marketdriven healthcare systems look to it for trends and ideas. As there seems to be much in the 2004 contract for GPs it will become a reference point for doctors in other international healthcare systems. Most governments seem to dread negotiations on pay and rations with doctors, as every new contract seems to come in over the dead bodies of the profession, who often discover well-hidden merits in the existing contract that a previous generation opposed. The merits in the 2004 contract for doctors and populations are not at all hidden, but a government may easily put aside its dread of doctors and decide to rebalance the benefits specifically in favour of the patient. In the Culture of Contentment, Galbraith wrote about how the selfinterested perspective of the well off could shape modern political and economic culture in the short term. A number of troubling questions emerge from a newfound contentment. Do the contented innovate, question, and advocate for patients or themselves? Is it possible to have some fellow feeling for the trials and tribulations of patients from a base of contentment? Will a contented profession with diminished autonomy be easily driven off course by externally set targets and politicians hell bent on improving the health of the nation for electoral advantage? For sure GPs in Denmark would like a bit more contentment — for now.